Provider Demographics
NPI:1104878859
Name:GUZEK, JAMES P (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:GUZEK
Suffix:
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:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0409
Mailing Address - Country:US
Mailing Address - Phone:360-242-3008
Mailing Address - Fax:360-807-7687
Practice Address - Street 1:6695 W RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3301
Practice Address - Country:US
Practice Address - Phone:509-736-0826
Practice Address - Fax:509-735-6868
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040667207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0157781OtherL & I
WA1002514Medicaid
ID8062921Medicaid
MT0048152Medicaid
WA3870GUOtherREGENCE-KENNEWICK
MTM000082437OtherMEDICARE MT
WA180043816OtherRAIL ROAD MEDICARE
WA180043815Medicare ID - Type UnspecifiedCHEHALIS RAILROAD MEDICAR
F04341Medicare UPIN
MT000082437Medicare ID - Type UnspecifiedGREAT FALLS MEDICARE NO
ID8062921Medicaid
WAGAB26366Medicare PIN
WA3870GUOtherREGENCE-KENNEWICK
ID180043901Medicare ID - Type UnspecifiedID RAILROAD MEDICARE
WA8296121Medicaid
WAG8863497Medicare PIN
OR226829Medicaid
MT0048152Medicaid
WAGAB26361Medicare PIN
WAGAB26362Medicare PIN