Healthcare Provider Details

I. General information

NPI: 1407814460
Provider Name (Legal Business Name): JAY MCMURREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E VIRGINIA AVE
GUNNISON CO
81230-2246
US

IV. Provider business mailing address

130 E VIRGINIA AVE
GUNNISON CO
81230-2246
US

V. Phone/Fax

Practice location:
  • Phone: 970-641-0211
  • Fax: 970-641-1268
Mailing address:
  • Phone: 970-641-0211
  • Fax: 970-641-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24727
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: