Individual
JOHN GORDON HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 679-9349
Mailing address
PO BOX 337420, GREELEY, CO 80633-0624
(970) 663-2742
(970) 667-0847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22264
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01222645
—
CO
01
—
930005396
RAILROAD MEDICARE
CO
Enumeration date
07/10/2006
Last updated
12/14/2010
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