Provider Demographics
NPI:1376544767
Name:SPURLOCK, JAMES RILEY III (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RILEY
Last Name:SPURLOCK
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:370 DOOLITTLE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-1129
Mailing Address - Country:US
Mailing Address - Phone:615-563-3245
Mailing Address - Fax:615-563-3247
Practice Address - Street 1:370 DOOLITTLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1129
Practice Address - Country:US
Practice Address - Phone:615-563-3245
Practice Address - Fax:615-563-3247
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TN1506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522449Medicaid
TN201365306OtherTAX ID
TN1524159Medicaid
TNBS8110835OtherDEA NUMBER
TNBS8110835OtherDEA NUMBER
TN201365306OtherTAX ID