Provider Demographics
NPI:1275288177
Name:W. BRUCE SCURLOCK, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:W. BRUCE SCURLOCK, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:SCURLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-324-0300
Mailing Address - Street 1:PO BOX 2287
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-2287
Mailing Address - Country:US
Mailing Address - Phone:661-324-0300
Mailing Address - Fax:
Practice Address - Street 1:2400 BAHAMAS DR STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0746
Practice Address - Country:US
Practice Address - Phone:661-324-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty