Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 04-32219 | KS |
N | 207Q00000X | Family Doctor | 50177 | CO |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 04-32219 | KS |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 50177 | CO |
NPI | 1134233919 |
---|---|
Provider Name | Dr. Joseph R Spurlock |
First Address | Wichita, KS 67202-3805 |
Second Address | Overland Park, KS 66210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04-32219 | KANSAS MEDICAL BOARD (01) | KS |
38530279 | (05) | CO |
50177 | COLORADO LICENSE (01) | CO |
G35155 | (02) | CO |