Provider Demographics
NPI:1447822085
Name:GURLEY, PATRICK CLEBURNE (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:CLEBURNE
Last Name:GURLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MIRAMONTE DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4393
Mailing Address - Country:US
Mailing Address - Phone:501-580-4751
Mailing Address - Fax:
Practice Address - Street 1:5917 BASELINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-5046
Practice Address - Country:US
Practice Address - Phone:501-565-7844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist