Basic Information
| Provider Information | |||||||||
| NPI: | 1396771366 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUILD | ||||||||
| FirstName: | CAMERON | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2153 DEPT 1947 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352870002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019925532 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 MARSHALL ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392021663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019696404 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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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 | 207RC0000X | 19382 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 19382 | MS | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | P00462208 | 01 | MS | RAILROAD MEDICARE PTAN | OTHER | P01228851 | 01 | MS | RR MEDICARE PTAN | OTHER | 05223367 | 05 | MS | MEDICAID | 7530834 | 01 | MS | AETNA | OTHER | P00350227 | 01 | MS | RAILROAD MEDICARE | OTHER | 1455687 | 05 | LA | MEDICAID |