Provider Demographics
NPI:1427091800
Name:SPURLING, RONALD D (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:SPURLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1561
Mailing Address - Country:US
Mailing Address - Phone:315-787-5322
Mailing Address - Fax:315-787-5318
Practice Address - Street 1:200 NORTH STREET
Practice Address - Street 2:SUITE102
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-2061
Practice Address - Country:US
Practice Address - Phone:315-787-5322
Practice Address - Fax:315-787-5318
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235443-1207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02662848Medicaid
NYP00424920OtherMEDICARE RAIL ROAD
NYP00424920OtherMEDICARE RAIL ROAD
NY02662848Medicaid
NYRA8893Medicare PIN