Provider Demographics
NPI:1801009220
Name:SPURGEON, DAVID PATRICK (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PATRICK
Last Name:SPURGEON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68059-5717
Mailing Address - Country:US
Mailing Address - Phone:402-253-3214
Mailing Address - Fax:402-253-3215
Practice Address - Street 1:10808 FORT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2076
Practice Address - Country:US
Practice Address - Phone:402-493-2323
Practice Address - Fax:402-965-9694
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE9826OtherLICENSE