| Doctor Name: | DR. RANDOLPH HOBSON GUTHRIE |
| NPI Number: | 1871858373 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 090152 |
| Business Practice Address: | 140 El Mirasol Palm Beach, FL - 334803611 |
| Business Phone Number: | 5616591496 |
| Business Fax Number: | 5618345886 |
| Mailing Address: | 140 El Mirasol, PALM BEACH |
| State: | FL |
| Postal Code: | 33480 |
| Phone Number: | 5616591496 |
| Fax Number: | 5618345886 |
| NPI Enumeration Date: | 07/10/2012 |
| NPI Last Update Date: | 07/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 229N00000X |
| License Number: | 090152 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Anaplastologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). |