Healthcare Provider Details

I. General information

NPI: 1942601638
Provider Name (Legal Business Name): JOHN GURLEY, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 SCHOOL ST STE B
MANCHESTER MA
01944-1700
US

IV. Provider business mailing address

195 SCHOOL ST STE B
MANCHESTER MA
01944-1700
US

V. Phone/Fax

Practice location:
  • Phone: 978-526-4800
  • Fax:
Mailing address:
  • Phone: 978-526-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN GURLEY
Title or Position: OWNER
Credential: M.D.
Phone: 978-526-4800