Provider Demographics
NPI:1912021494
Name:GUIDO, GARY JOHN (OD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:JOHN
Last Name:GUIDO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5399 LAUBY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1554
Mailing Address - Country:US
Mailing Address - Phone:330-494-8814
Mailing Address - Fax:330-494-1902
Practice Address - Street 1:5399 LAUBY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1554
Practice Address - Country:US
Practice Address - Phone:330-494-8814
Practice Address - Fax:330-494-1902
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3534 T1759152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist