Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 020599 | LA |
Y | 207K00000X | Allergist & Immunologist | 2021-01998 | NC |
NPI | 1164490330 |
---|---|
Provider Name | Dr. Richard J Guillot |
First Address | High Point, NC 27262-4303 |
Second Address | High Point, NC 27262-4303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164490330 | (05) | NC |
1905445 | (05) | LA |
E57308 | (02) | LA |