Provider Demographics
NPI:1629306444
Name:NEAL HAMILTON GUFFEY, JR. MD PLLC
Entity Type:Organization
Organization Name:NEAL HAMILTON GUFFEY, JR. MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:GUFFEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD PLLC
Authorized Official - Phone:336-768-4460
Mailing Address - Street 1:755 HIGHLAND OAKS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7106
Mailing Address - Country:US
Mailing Address - Phone:336-768-4460
Mailing Address - Fax:336-659-8759
Practice Address - Street 1:755 HIGHLAND OAKS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7106
Practice Address - Country:US
Practice Address - Phone:336-768-4460
Practice Address - Fax:336-659-8759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500489207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF76849Medicare UPIN