Provider Demographics
NPI:1205876083
Name:GUYTON, EUGENE DANIEL JR (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:DANIEL
Last Name:GUYTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4725
Mailing Address - Country:US
Mailing Address - Phone:843-662-3423
Mailing Address - Fax:843-667-6842
Practice Address - Street 1:214 W PINE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4725
Practice Address - Country:US
Practice Address - Phone:843-662-3423
Practice Address - Fax:843-667-6842
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8524174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC085240Medicaid
SC1451Medicare ID - Type Unspecified
SCB92124Medicare UPIN