Provider Demographics
NPI:1417316191
Name:RONALD GUILEY OD, MPH, PC
Entity Type:Organization
Organization Name:RONALD GUILEY OD, MPH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GUILEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD, MPH
Authorized Official - Phone:541-388-7906
Mailing Address - Street 1:63455 N HWY 97
Mailing Address - Street 2:STE 75
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-6764
Mailing Address - Country:US
Mailing Address - Phone:541-388-7906
Mailing Address - Fax:541-388-8190
Practice Address - Street 1:63455 N HWY 97
Practice Address - Street 2:STE 75
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703
Practice Address - Country:US
Practice Address - Phone:541-388-7906
Practice Address - Fax:541-388-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1537ATI261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty