Healthcare Provider Details

I. General information

NPI: 1114976370
Provider Name (Legal Business Name): JAMES MATTHEW HURLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD SUITE 116
AMARILLO TX
79119-6407
US

IV. Provider business mailing address

PO BOX 51525
AMARILLO TX
79159-1525
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-7286
  • Fax:
Mailing address:
  • Phone: 806-355-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberJ7996
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: