Provider Demographics
NPI:1497704803
Name:GUFFIN, BRIAN TRUETT (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TRUETT
Last Name:GUFFIN
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5604
Mailing Address - Country:US
Mailing Address - Phone:205-933-1199
Mailing Address - Fax:205-212-5585
Practice Address - Street 1:3400 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5604
Practice Address - Country:US
Practice Address - Phone:205-933-1199
Practice Address - Fax:205-212-5585
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015312174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009932604Medicaid
AL009932604Medicaid
AL051528173Medicare ID - Type Unspecified