Provider Demographics
NPI:1316946163
Name:GUTHRIE, JAMES BRETT (DC, APRN)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRETT
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:DC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SPIRO
Mailing Address - State:OK
Mailing Address - Zip Code:74959-3041
Mailing Address - Country:US
Mailing Address - Phone:918-962-2439
Mailing Address - Fax:918-967-8847
Practice Address - Street 1:2000 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SPIRO
Practice Address - State:OK
Practice Address - Zip Code:74959-3041
Practice Address - Country:US
Practice Address - Phone:918-962-2439
Practice Address - Fax:918-967-8847
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2510111N00000X
OKR0100325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731329245001OtherBCBS SPIRO PROV NUMBER
OK731329245001OtherBCBS SPIRO PROV NUMBER
OKT86473Medicare UPIN