Provider Demographics
NPI:1376599399
Name:RUTH W GUYER M.D., PA
Entity Type:Organization
Organization Name:RUTH W GUYER M.D., PA
Other - Org Name:ANCHOR MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-353-4991
Mailing Address - Street 1:PO BOX 12457
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-2457
Mailing Address - Country:US
Mailing Address - Phone:910-353-4991
Mailing Address - Fax:910-353-6410
Practice Address - Street 1:217 STATION ST
Practice Address - Street 2:EFFECTIVE 1 JULY 2010, CHANGE TO 1 MATTHEW COURT
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6304
Practice Address - Country:US
Practice Address - Phone:910-353-4991
Practice Address - Fax:910-353-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31024207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1174537096OtherINDIV NPI
NC37979OtherBCBS
NC7937979Medicaid
NC7937979Medicaid
NC1174537096OtherINDIV NPI