Provider Demographics
NPI:1942680269
Name:GORMLEY, ROBERT P (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GORMLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 HIGHWAY 98 LABORATORY DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512
Mailing Address - Country:US
Mailing Address - Phone:412-759-2750
Mailing Address - Fax:
Practice Address - Street 1:6000 HIGHWAY 98 LABORATORY DEPARTMENT
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-2197
Practice Address - Country:US
Practice Address - Phone:412-759-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245969207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17209926OtherPENNSYLVANIA DRIVER LICENSE NUMBER