Basic Information
Provider Information
NPI: 1912394958
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUTH
FirstName: JOSEPH
MiddleName: JARED
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4605 SAWMILL RD
Address2:  
City: UPPER ARLINGTON
State: OH
PostalCode: 432202246
CountryCode: US
TelephoneNumber: 6145457900
FaxNumber:  
Practice Location
Address1: 460 W CENTRAL AVE
Address2:  
City: DELAWARE
State: OH
PostalCode: 430151435
CountryCode: US
TelephoneNumber: 6148278700
FaxNumber: 6148278701
Other Information
ProviderEnumerationDate: 04/16/2015
LastUpdateDate: 08/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X35.142510OHN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005X35.142510OHY Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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