Provider Demographics
NPI:1528070786
Name:GUYDEN, THOMAS EARL (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EARL
Last Name:GUYDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 E FLAMINGO RD
Mailing Address - Street 2:#2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5274
Mailing Address - Country:US
Mailing Address - Phone:702-650-0633
Mailing Address - Fax:702-650-0642
Practice Address - Street 1:6161 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-486-6091
Practice Address - Fax:702-486-0411
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV108202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505872Medicaid
NVPENDNGMedicare ID - Type Unspecified