Individual
ROBERT D GOURLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 S BRYANT AVE, STE 100, EDMOND, OK 73034-5797
(405) 341-4238
(405) 340-0269
Mailing address
920 S BRYANT AVE, STE 100, EDMOND, OK 73034-5797
(405) 341-4238
(405) 340-0269
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10888
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100212730A
—
OK
Enumeration date
10/17/2005
Last updated
11/13/2009
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