Provider Demographics
NPI:1790750172
Name:GUENTHER, JOSEPH MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:GUENTHER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:MICHAEL
Other - Last Name:GUENTHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-344-1600
Mailing Address - Fax:859-344-0091
Practice Address - Street 1:20 MEDICAL VILLAGE DR STE 254
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5401
Practice Address - Country:US
Practice Address - Phone:859-344-1600
Practice Address - Fax:859-344-0091
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350803792086X0206X
KY372992086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200416820AMedicaid
OH2309540Medicaid
KYP00629651OtherRAILROAD MEDICARE
OH020051757OtherRAILROAD MEDICARE
KY64056765Medicaid
KY7100056850Medicaid
OHF41154Medicare UPIN
OH2309540Medicaid
IN200416820AMedicaid
OH020051757Medicare PIN
KY1459517Medicare PIN
OH020051757Medicare PIN