Provider Demographics
NPI:1346671153
Name:SPURLOCK, LISA XIAO (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:XIAO
Last Name:SPURLOCK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4315 DIPLOMACY DR
Mailing Address - Street 2:ALASKA NATIVE MEDICAL CENTER-UROLOGY CLINIC
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5926
Mailing Address - Country:US
Mailing Address - Phone:907-729-1973
Mailing Address - Fax:907-729-1542
Practice Address - Street 1:4315 DIPLOMACY DR
Practice Address - Street 2:ALASKA NATIVE MEDICAL CENTER-UROLOGY CLINIC
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5926
Practice Address - Country:US
Practice Address - Phone:907-729-1973
Practice Address - Fax:907-729-1542
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
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Provider Licenses
StateLicense IDTaxonomies
AK2299363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant