Provider Demographics
NPI:1427095330
Name:GUENTHNER, PAUL R (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:GUENTHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-757-0717
Mailing Address - Fax:859-331-2425
Practice Address - Street 1:351 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3477
Practice Address - Country:US
Practice Address - Phone:859-757-0717
Practice Address - Fax:859-334-2425
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23874207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64238744Medicaid
KY100009312OtherRAILROAD MEDICARE
KYP00821191OtherRAILROAD MEDICARE
OH0696859Medicaid
KY100009312OtherRAILROAD MEDICARE
KY0387701Medicare PIN
KY008580067Medicare PIN