Provider Demographics
NPI:1336395516
Name:JEROLD P. GURLEY M.D. , P.C. , INC.
Entity Type:Organization
Organization Name:JEROLD P. GURLEY M.D. , P.C. , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROLD
Authorized Official - Middle Name:P
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-816-2225
Mailing Address - Street 1:7215 OLD OAK BLVD
Mailing Address - Street 2:SUITE A421
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3340
Mailing Address - Country:US
Mailing Address - Phone:440-816-2225
Mailing Address - Fax:440-816-2229
Practice Address - Street 1:7215 OLD OAK BLVD
Practice Address - Street 2:SUITE A421
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3340
Practice Address - Country:US
Practice Address - Phone:440-816-2225
Practice Address - Fax:440-816-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0891872Medicare PIN