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General NPI Number Information
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NPI Number | 1760454235
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Entity Type | Individual
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Provider Name | GREGORY ALAN FLURY PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 424 YELLOWSTONE AVE STE 120
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City | CODY
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State | WY
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Zip | 82414-9311
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Country | US
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Telephone | 307-578-2903
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Fax | 307-578-2937
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Provider Business Mailing Address
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Address Line | 424 YELLOWSTONE AVE STE 120
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City | CODY
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State | WY
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Zip | 82414-9311
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Country | US
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Telephone | 307-578-2903
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Fax | 307-578-2937
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2028
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 4149
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1009
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License Number State | WY
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