Provider Demographics
NPI:1457317257
Name:MIOTON, GUY BRITTON (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:BRITTON
Last Name:MIOTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7261
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:1840 MEDICAL CENTER PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3199
Practice Address - Country:US
Practice Address - Phone:615-867-5028
Practice Address - Fax:615-867-6650
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40745207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001092Medicaid
LA1194042Medicaid
TNP00620880OtherRR MEDICARE
TN6011949OtherBLUE CROSS-BLUE SHIELD
LA1194042Medicaid
TN3001092Medicare PIN
TNP00620880OtherRR MEDICARE
LA53350Medicare ID - Type Unspecified