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Individual

DR. DAVID SCOTT GOURLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6065 S FASHION BLVD, STE 255, MURRAY, UT 84107-7381
(801) 266-4115
(801) 266-4138
Mailing address
1660 W ANTELOPE DR, STE 225, LAYTON, UT 84041-1156
(801) 775-9800
(801) 775-9806

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
90-183859-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030001480
RAILROAD MEDICARE
01
1838591205
UT PROFESSIONAL LICENSE
UT
Enumeration date
06/01/2005
Last updated
04/03/2013
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