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Organization

LEONARD D. GUTH MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEONARD D GUTH M.D. (OWNER)
(208) 661-7037
Entity
Organization

Contact information

Practice address
5424 N MARTHA LOOP, COEUR D ALENE, ID 83815-9143
(208) 661-7037
Mailing address
5424 N MARTHA LOOP, COEUR D ALENE, ID 83815-9143

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M5099
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DB4464
RAILROAD MEDICARE
ID
Enumeration date
06/12/2007
Last updated
11/01/2007
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