Provider Demographics
NPI:1356785117
Name:GUTHRIE, JAMES THOMAS JR (BS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:GUTHRIE
Suffix:JR
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BEAUVOIR RD STE 3
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4026
Mailing Address - Country:US
Mailing Address - Phone:228-388-2900
Mailing Address - Fax:228-388-2060
Practice Address - Street 1:250 BEAUVOIR RD STE 3
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4026
Practice Address - Country:US
Practice Address - Phone:228-388-2900
Practice Address - Fax:228-388-2060
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018214Medicaid