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NPI Code Detail

MEDICARE: DR. DANIEL V SPURLOCK D.O.

MEDICARE: DR. DANIEL V SPURLOCK D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2006012818MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00390416OTHERMOMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
237433024OTHERMOBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1013957257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL V SPURLOCK D.O.
Provider Business Mailing Address
First Line : 211 NE 54TH ST
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64118-4390
Country : US
Telephone Number : 816-453-6777
Fax Number : 816-464-3601
Provider Business Practice Location Address
First Line : 211 NE 54TH ST
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64118-4390
Country : US
Telephone Number : 816-453-6777
Fax Number : 816-464-3601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 04/01/2014

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Directions to “ DR. DANIEL V SPURLOCK D.O.” Practice Location

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