Provider Demographics
NPI:1447345178
Name:GUINN, TIM (DPH)
Entity type:Individual
Prefix:DR
First Name:TIM
Middle Name:
Last Name:GUINN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 N.W. 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127
Mailing Address - Country:US
Mailing Address - Phone:405-946-4375
Mailing Address - Fax:405-946-4505
Practice Address - Street 1:4911 N.W. 23RD STREET
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127
Practice Address - Country:US
Practice Address - Phone:405-946-4375
Practice Address - Fax:405-946-4505
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist