Provider Demographics
NPI:1316051113
Name:SPURLOCK, THOMAS GLENN (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:GLENN
Last Name:SPURLOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 CANYON ROAD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-822-8320
Mailing Address - Fax:205-822-8323
Practice Address - Street 1:2017 CANYON ROAD
Practice Address - Street 2:SUITE 21
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-822-8320
Practice Address - Fax:205-822-8323
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051511150OtherBCBS OF AL
AL051513649OtherBCBS OF AL
AL890009600Medicaid
AL890009910Medicaid
515-11149OtherBC/BS OF ALABAMA
AL051511149OtherBCBS OF AL
AL051552069Medicaid
AL051511150OtherBCBS OF AL
515-11149OtherBC/BS OF ALABAMA
AL890009600Medicaid