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General NPI Number Information
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NPI Number | 1407812936
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Entity Type | Individual
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Provider Name | JEROME OSCAR SPRUILL MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 1307 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-6307
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Country | US
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Telephone | 336-273-6911
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Fax | 336-273-9999
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Provider Business Mailing Address
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Address Line | 5102 DUNSTAN RD
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City | GREENSBORO
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State | NC
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Zip | 27405-9565
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Country | US
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Telephone | 336-375-6109
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Fax | 336-375-6676
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 28092
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License Number State | NC
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