Provider Demographics
NPI:1962749986
Name:KURT W SPRUNGER MD PLC
Entity type:Organization
Organization Name:KURT W SPRUNGER MD PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SPRUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-422-9690
Mailing Address - Street 1:3805 E BELL RD
Mailing Address - Street 2:SUITE 5300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2105
Mailing Address - Country:US
Mailing Address - Phone:602-422-9690
Mailing Address - Fax:
Practice Address - Street 1:3805 E BELL RD
Practice Address - Street 2:SUITE 5300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2105
Practice Address - Country:US
Practice Address - Phone:602-422-9690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37779208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty