Provider Demographics
NPI:1124085485
Name:VOELLER, GUY R (MD)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:R
Last Name:VOELLER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6029 WALNUT GROVE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2112
Mailing Address - Country:US
Mailing Address - Phone:901-866-8530
Mailing Address - Fax:901-302-2530
Practice Address - Street 1:6029 WALNUT GROVE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2112
Practice Address - Country:US
Practice Address - Phone:901-866-8530
Practice Address - Fax:901-302-2530
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN14346208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR113511001Medicaid
MS1124085485Medicaid
TN3026485Medicaid