Healthcare Provider Details

I. General information

NPI: 1417058611
Provider Name (Legal Business Name): JOHN GURLEY, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 SCHOOL ST SUITE B
MANCHESTER MA
01944-1700
US

IV. Provider business mailing address

195 SCHOOL ST SUITE B
MANCHESTER MA
01944-1700
US

V. Phone/Fax

Practice location:
  • Phone: 978-526-4800
  • Fax: 978-526-7179
Mailing address:
  • Phone: 978-526-4800
  • Fax: 978-526-7179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

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