Individual
AUDREY C. GUTHRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1205 BELLEVILLE AVE, BREWTON, AL 36426-1304
(251) 867-3608
(251) 867-3610
Mailing address
1205 BELLEVILLE AVE, BREWTON, AL 36426-1304
(251) 867-3608
(251) 867-3610
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
PA-395
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009969685
—
AL
01
—
51524734GUT
BC/BS OF ALABAMA
AL
Enumeration date
11/10/2005
Last updated
04/29/2011
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