Provider Demographics
NPI:1265492383
Name:HURLEY, JAMES RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAYMOND
Last Name:HURLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 ADELAIDE HLS
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-6222
Mailing Address - Country:US
Mailing Address - Phone:724-626-2044
Mailing Address - Fax:
Practice Address - Street 1:2620 MEMORIAL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1488
Practice Address - Country:US
Practice Address - Phone:724-626-8890
Practice Address - Fax:724-626-2983
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004033L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011633880002Medicaid
PAJR711503OtherGROUP NUMBER
PA62156OtherUNISON
PA0004542737OtherAETNA INSURANCE
PA0012691440002Medicaid
PA309990OtherUPMC
PA1500256OtherGATEWAY
PA415912OtherHEALTH AMERICA
PA415912OtherHEALTH AMERICA
PA0011633880002Medicaid