Organization
COMMUNITY FAMILY PRACTICE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MILTON SPRUILL JR. M.D. (PRESIDENT)
(252) 335-0503
Entity
Organization
Contact information
Practice address
107 MEDICAL DR, ELIZABETH CITY, NC 27909-3361
(252) 335-0503
Mailing address
107 MEDICAL DR, ELIZABETH CITY, NC 27909-3361
(252) 335-0503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19404
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D0242422
CLIA ID NUMBER
—
05
—
5950232
—
NC
Enumeration date
02/08/2007
Last updated
02/24/2011
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