Organization
SOUTHEASTERN PAIN & REHABILITATION PHYSICIANS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY L SPRUILL MD (PRESIDENT)
(205) 759-7246
Entity
Organization
Contact information
Practice address
1050 RUBY TYLER PKWY, TUSCALOOSA, AL 35404-2958
(205) 759-7246
(205) 759-7348
Mailing address
PO BOX 934585, ATLANTA, GA 31193-4585
(800) 897-6169
(800) 897-6170
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529901330
—
AL
01
—
DA7618
MEDICARE RAILROAD
AL
01
—
G111
BC OF AL
AL
Enumeration date
09/07/2005
Last updated
01/06/2010
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