Basic Information
| Provider Information | |||||||||
| NPI: | 1659559276 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HURLEY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | P.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 843298 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022843298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9108785100 | ||||||||
| FaxNumber: | 9108785140 | ||||||||
| Practice Location | |||||||||
| Address1: | 6322 FAYETTEVILLE ROAD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | RAEFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283767998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9108785100 | ||||||||
| FaxNumber: | 9108785140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2008 | ||||||||
| LastUpdateDate: | 10/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 0010-01238 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.