Provider Demographics
NPI:1932187606
Name:GURLEY, FIONNUALA M (MD)
Entity Type:Individual
Prefix:
First Name:FIONNUALA
Middle Name:M
Last Name:GURLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N MONTE VISTA ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4674
Mailing Address - Country:US
Mailing Address - Phone:580-332-2323
Mailing Address - Fax:580-272-1660
Practice Address - Street 1:520 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4674
Practice Address - Country:US
Practice Address - Phone:580-332-2323
Practice Address - Fax:580-272-1660
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25972207RC0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H24290Medicare UPIN