Provider Demographics
NPI:1396899951
Name:GERALDINE W SPURLIN MD PSC
Entity type:Organization
Organization Name:GERALDINE W SPURLIN MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SPURLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSC
Authorized Official - Phone:859-623-1404
Mailing Address - Street 1:789 EASTERN BYP
Mailing Address - Street 2:SUITE 21
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2415
Mailing Address - Country:US
Mailing Address - Phone:859-623-1404
Mailing Address - Fax:859-623-1405
Practice Address - Street 1:789 EASTERN BYP
Practice Address - Street 2:SUITE 21
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2415
Practice Address - Country:US
Practice Address - Phone:859-523-1404
Practice Address - Fax:859-623-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1229101Medicare ID - Type Unspecified
C71889Medicare UPIN