Healthcare Provider Details

I. General information

NPI: 1407899172
Provider Name (Legal Business Name): JOHN W. SPURLOCK MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 E BROAD ST
BETHLEHEM PA
18018-6336
US

IV. Provider business mailing address

433 E BROAD ST
BETHLEHEM PA
18018-6336
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-5780
  • Fax:
Mailing address:
  • Phone: 610-868-5780
  • Fax: 610-868-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number035725E
License Number StatePA

VIII. Authorized Official

Name: JOHN W SPURLOCK
Title or Position: OWNER
Credential: MD
Phone: 610-868-5780