Healthcare Provider Details

I. General information

NPI: 1396974044
Provider Name (Legal Business Name): JUSTIN MILES SPRATT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 J D ANDERSON DR
MORGANTOWN WV
26505-3494
US

IV. Provider business mailing address

1200 J D ANDERSON DR
MORGANTOWN WV
26505-3494
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-1200
  • Fax: 304-598-1699
Mailing address:
  • Phone: 304-598-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2847
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOT012880
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT012880
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: