Individual
DR. MAYNARD B SPURLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-3352
Mailing address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-3352
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015042
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
KY
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
06/07/2022
Last updated
06/07/2022
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