Provider Demographics
NPI:1801551767
Name:SPOR, JULIA LEIGH
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:LEIGH
Last Name:SPOR
Suffix:
Gender:F
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8788 KENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3596
Mailing Address - Country:US
Mailing Address - Phone:919-749-8332
Mailing Address - Fax:
Practice Address - Street 1:6750 TRYON RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7056
Practice Address - Country:US
Practice Address - Phone:919-378-2332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2024-01-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant