Healthcare Provider Details

I. General information

NPI: 1649379611
Provider Name (Legal Business Name): JEFFREY P HURLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PAOLI PIKE
WEST CHESTER PA
19380-4642
US

IV. Provider business mailing address

1101 PAOLI PIKE
WEST CHESTER PA
19380-4642
US

V. Phone/Fax

Practice location:
  • Phone: 610-918-2500
  • Fax:
Mailing address:
  • Phone: 610-918-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD041426E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: