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Individual
JIMMY W. SPRUILL
Active
Individual
JIMMY W. SPRUILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
F2033
TX
207Q00000X
Family Medicine Physician
Primary
F2033
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1399511-25
—
TX
01
—
5645622
AETNA
TX
01
—
8142853
CIGNA
TX
01
—
8R0098
BLUE CROSS BLUE SHIELD
TX
01
—
P00264261
RAILROAD MEDICARE
TX
Enumeration date
01/12/2007
Last updated
04/28/2014
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