Individual
MS. VICKY L GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
101 PROGRESS PKWY, SULLIVAN, MO 63080-2359
(844) 853-8937
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(877) 406-2662
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2007013967
MO
207Q00000X
Family Medicine Physician
Primary
2007013967
MO
207Q00000X
Family Medicine Physician
2007013987
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207308206
—
MO
Enumeration date
07/06/2007
Last updated
12/16/2022
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