Provider Demographics
NPI:1629052378
Name:GURLEY, LARRY DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DEAN
Last Name:GURLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:300 20TH AVE N
Practice Address - Street 2:SUITE 102
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2132
Practice Address - Country:US
Practice Address - Phone:615-284-1500
Practice Address - Fax:615-284-1501
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11691207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0023517OtherBC/BS TN
TN3199048Medicaid
TN3199048Medicaid
TN3199048Medicare ID - Type Unspecified
TNB04831Medicare UPIN