Provider Demographics
NPI:1154503878
Name:ALLEN C GUEHL DPM INC
Entity type:Organization
Organization Name:ALLEN C GUEHL DPM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-252-9653
Mailing Address - Street 1:1836 ASH MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-9595
Mailing Address - Country:US
Mailing Address - Phone:937-427-4073
Mailing Address - Fax:866-304-2735
Practice Address - Street 1:204 S BELMONT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1224
Practice Address - Country:US
Practice Address - Phone:937-322-7607
Practice Address - Fax:866-304-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003114G213ES0103X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2156965Medicaid
OH1319840001Medicare NSC
OH0887064Medicare PIN
OHU76415Medicare UPIN