Provider Demographics
NPI:1457640674
Name:JAMES R SPURLOCK III DO
Entity Type:Organization
Organization Name:JAMES R SPURLOCK III DO
Other - Org Name:MOUNTAIN VIEW MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-563-3245
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1506207Q00000X
TN5683363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty