Individual
DR. JERRY GAINES PURVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5034 N WALNUT ST, SOUTH BLOOMFIELD, OH 43103-1018
(740) 983-8346
(740) 983-6600
Mailing address
5034 N WALNUT ST, SOUTH BLOOMFIELD, OH 43103-1018
(740) 983-8346
(740) 983-6600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-08-0726-P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2297232
—
OH
Enumeration date
08/11/2006
Last updated
01/19/2010
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