Healthcare Provider Details

I. General information

NPI: 1982346912
Provider Name (Legal Business Name): GREGORY JOHN HURLEY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

IV. Provider business mailing address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

V. Phone/Fax

Practice location:
  • Phone: 504-468-8600
  • Fax:
Mailing address:
  • Phone: 504-468-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number346150
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: