Individual
DR. EDMUND REED GURNEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
324 4TH STREET, MYRTLE POINT, OR 97458-1066
(541) 572-2111
(541) 572-5743
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD10881
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
NBMC NPI NUMBER-GROUP
OR
05
—
234328
—
OR
01
—
930635514
GROUP TAX NUMBER
OR
01
—
CB3544
RR MEDICARE GROUP NUMBER
OR
01
—
P00288564
RR MEDICARE PTAN NUMBER
OR
01
—
R0000WFBTV
GROUP PIN NUMBER
OR
Enumeration date
12/06/2005
Last updated
03/23/2010
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