Provider Demographics
NPI:1750375291
Name:GUTHRIE, DAVID P (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1700 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024
Mailing Address - Country:US
Mailing Address - Phone:731-287-4500
Mailing Address - Fax:731-287-4804
Practice Address - Street 1:1700 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-287-4500
Practice Address - Fax:731-287-4804
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD019073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0440228OtherUNITED HEALTHCARE
TN3051685Medicaid
TN0106846OtherBLUE CROSS
407113848OtherPALMETTO GBA
116447OtherBETTER HEALTH PLAN
7141OtherTLC MEMPHIS MANAGED CARE
8005288OtherCIGNA
5281070OtherAETNA
116447OtherBETTER HEALTH PLAN
8005288OtherCIGNA