Provider Demographics
NPI:1508920539
Name:GUFFEY, MATTHEW W (PA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:W
Last Name:GUFFEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 HIGHWAY 280 STE 210
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5186
Mailing Address - Country:US
Mailing Address - Phone:205-971-8000
Mailing Address - Fax:205-971-8020
Practice Address - Street 1:4600 HIGHWAY 280 STE 210
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5186
Practice Address - Country:US
Practice Address - Phone:205-971-8000
Practice Address - Fax:205-971-8020
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.311363A00000X
GA004541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP003952Medicare ID - Type Unspecified