Provider Demographics
NPI:1285783720
Name:GUYOT, DOUGLAS REED (DC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:REED
Last Name:GUYOT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 DOLLY PARTON PKWY UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-3619
Mailing Address - Country:US
Mailing Address - Phone:865-429-4404
Mailing Address - Fax:865-429-4091
Practice Address - Street 1:739 DOLLY PARTON PKWY UNIT B
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3619
Practice Address - Country:US
Practice Address - Phone:865-429-4404
Practice Address - Fax:865-429-4091
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3676338Medicare ID - Type Unspecified
TNT-41679Medicare UPIN