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NPI Code Detail

MEDICARE: THOMAS S GORMLEY MD

MEDICARE: THOMAS S GORMLEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician98-61NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497721948
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS S GORMLEY MD
Provider Business Mailing Address
First Line : 2545 S DON ROSER DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-9107
Country : US
Telephone Number : 575-522-7880
Fax Number : 575-522-7226
Provider Business Practice Location Address
First Line : 2545 S DON ROSER DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-9107
Country : US
Telephone Number : 575-522-7880
Fax Number : 575-522-7226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2006
Last Update Date : 07/02/2013

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