| Spurling And White Llc | |
|
100 W. 17th Street Ste D Mountain Grove MO 65711 | |
| (417) 255-8645 | |
| (417) 255-8649 |
| Full Name | Spurling And White Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 W. 17th Street, Mountain Grove, Missouri |
| Authorized Official Name and Position | Jason K Spurling (OWNER) |
| Authorized Official Contact | 4172558645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spurling And White Llc 1307 Porter Wagoner Blvd. West Plains MO 65775 Ph: (417) 255-8645 | Spurling And White Llc 100 W. 17th Street Ste D Mountain Grove MO 65711 Ph: (417) 255-8645 |
| NPI Number | 1912476300 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 2365788213 |
|---|---|
| Medicare Enrollment ID | O20190114001594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912476300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Jason K Spurling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770661704 PECOS PAC ID: 6204892953 Enrollment ID: I20041206000155 |
| Provider Name | K Madalyn Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891954699 PECOS PAC ID: 7416022348 Enrollment ID: I20080812000581 |
| Provider Name | Sheena K White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881000198 PECOS PAC ID: 8022237494 Enrollment ID: I20140917000623 |
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