Provider Demographics
NPI:1972573186
Name:GURLEY, STEVEN CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHRISTOPHER
Last Name:GURLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:GURLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:309 S. TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-6429
Mailing Address - Country:US
Mailing Address - Phone:580-436-2020
Mailing Address - Fax:580-436-0404
Practice Address - Street 1:309 S. TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-6429
Practice Address - Country:US
Practice Address - Phone:580-436-2020
Practice Address - Fax:580-436-0404
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2064152W00000X
OKOK2064152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0727490001OtherPALMETTO
OK100763290BMedicaid
OKU34734Medicare UPIN
OK410035923Medicare ID - Type UnspecifiedMEDICARE RAILROAD RETIREM
OK0727490001Medicare NSC