Individual
SPURGEON WILLIAM CLARK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
502 ISABELLA STREET, WAYCROSS, GA 31501-3638
(912) 285-2020
(912) 285-8112
Mailing address
P.O. BOX 2009, WAYCROSS, GA 31502-2009
(912) 285-2020
(912) 285-8112
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
024916
GA
207W00000X
Ophthalmology Physician
24916
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000264547B
—
GA
01
—
024581
BCBS
GA
01
—
180011242
MEDICARE RR
GA
Enumeration date
04/25/2008
Last updated
09/15/2016
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