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General NPI Number Information
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NPI Number | 1306986278
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY PRACTICE PHYSICIANS
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 107 MEDICAL DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3361
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Country | US
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Telephone | 252-335-0503
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Fax |
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Provider Business Mailing Address
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Address Line | 107 MEDICAL DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3361
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Country | US
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Telephone | 252-335-0503
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH MILTON SPRUILL JR.
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Credential | M.D.
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Telephone | 252-335-0503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19404
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License Number State | NC
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