Provider Demographics
NPI:1417058611
Name:JOHN GURLEY, MD, PC
Entity Type:Organization
Organization Name:JOHN GURLEY, MD, PC
Other - Org Name:GURLEY EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-526-4800
Mailing Address - Street 1:195 SCHOOL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1700
Mailing Address - Country:US
Mailing Address - Phone:978-526-4800
Mailing Address - Fax:978-526-7179
Practice Address - Street 1:195 SCHOOL ST
Practice Address - Street 2:SUITE B
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1700
Practice Address - Country:US
Practice Address - Phone:978-526-4800
Practice Address - Fax:978-526-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9771212Medicaid
1149320001OtherMEDICARE DME SPECIALTY
MA696412OtherTUFTS
1149320001OtherMEDICARE DME SPECIALTY