Basic Information
| Provider Information | |||||||||
| NPI: | 1376693317 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUINEY | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 RIDGEWAY ST | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287795494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282220416 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | CHEROKEE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284979163 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 12/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2014-00119 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | MD00047012 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2014-00119 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1629236716 | 05 | AZ | MEDICAID | 1780614008 | 05 | AZ | MEDICAID | 1295993376 | 05 | AZ | MEDICAID | 1871523191 | 05 | AZ | MEDICAID |