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General NPI Number Information
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NPI Number | 1568465771
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Entity Type | Individual
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Provider Name | RONALD RAY SPRUILL JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 100 OAK LEE DRIVE
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City | RANSON
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State | WV
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Zip | 25438
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Country | US
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Telephone | 304-930-0001
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Fax | 681-252-1843
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Provider Business Mailing Address
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Address Line | 220 CAMPUS BLVD STE 100
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City | WINCHESTER
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State | VA
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Zip | 22601-2896
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Country | US
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Telephone | 540-536-5100
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Fax | 540-536-0235
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0002450
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007496
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2256
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License Number State | WV
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