Provider Demographics
NPI:1922167030
Name:SPURLING, ROBERT LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:SPURLING
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:9119 MERRILL RD
Mailing Address - Street 2:STE 13
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4307
Mailing Address - Country:US
Mailing Address - Phone:904-743-6410
Mailing Address - Fax:904-745-9942
Practice Address - Street 1:9119 MERRILL RD
Practice Address - Street 2:STE 13
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-4307
Practice Address - Country:US
Practice Address - Phone:904-743-6410
Practice Address - Fax:904-745-9942
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL1058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19151Medicare PIN
FL407540589Medicare PIN