Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5410 | AL |
NPI | 1033287008 |
---|---|
Provider Name | Dr. Kenneth C Guffey |
First Address | Huntsville, AL 35801-3759 |
Second Address | Huntsville, AL 35801-3759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 29/12/2011 |