Provider Demographics
NPI:1306487525
Name:KENNETH J GUTH MD PC
Entity type:Organization
Organization Name:KENNETH J GUTH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-807-4264
Mailing Address - Street 1:4 CENTRE DR STE G
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4117
Mailing Address - Country:US
Mailing Address - Phone:716-740-1700
Mailing Address - Fax:855-879-6594
Practice Address - Street 1:4 CENTRE DR STE G
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4117
Practice Address - Country:US
Practice Address - Phone:716-740-1700
Practice Address - Fax:855-879-6594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty