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General NPI Number Information
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NPI Number | 1396831558
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Entity Type | Individual
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Provider Name | GIZELLE A SPURGEON MD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 12/13/2014
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Provider Practice Location Address
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Address Line | 23 CALLE AGUILA
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City | SANTA FE
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State | NM
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Zip | 87508-5900
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Country | US
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Telephone | 505-471-2241
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Fax |
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Provider Business Mailing Address
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Address Line | 23 CALLE AGUILA
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City | SANTA FE
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State | NM
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Zip | 87508-5900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25032
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD2008-0377
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License Number State | NM
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