Provider Demographics
NPI:1821156282
Name:DR. W. DAVID SPRUILL & ASSOCIATES
Entity Type:Organization
Organization Name:DR. W. DAVID SPRUILL & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-288-2202
Mailing Address - Street 1:1601 WILLOW LAWN DR
Mailing Address - Street 2:SUITE 254
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3427
Mailing Address - Country:US
Mailing Address - Phone:804-288-2202
Mailing Address - Fax:804-282-9155
Practice Address - Street 1:1601 WILLOW LAWN DR
Practice Address - Street 2:SUITE 254
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3427
Practice Address - Country:US
Practice Address - Phone:804-288-2202
Practice Address - Fax:804-282-9155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC02541Medicare PIN