Dr. Michael Bryon Spackman
Pain Medicine
360 E Montvue Dr Suite 100
Meridian
, Idaho 83642
Dr. Michael Bryon Spackman
Pain Medicine
360 E Montvue Dr Suite 100
Meridian
, Idaho 83642
(952) 239-5080
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About
Features
Specialties
- Pain Medicine
Languages spoken
- English
Location
First Address
- Dr. Michael Bryon Spackman
- 2835 N Tanglerose Pl
- Eagle, ID
- Zip : 83616-5796
- Phone : (952) 239-5080
Second Address
- Dr. Michael Bryon Spackman
- 360 E Montvue Dr Suite 100
- Meridian, ID
- Zip : 83642
- Phone : (208) 855-2900
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081P2900X | Pain Medicine | M11335 | ID |
National Provider Identifier
| NPI | 1386887032 |
|---|---|
| Provider Name | Dr. Michael Bryon Spackman |
| First Address | Eagle, ID 83616-5796 |
| Second Address | Meridian, ID 83642 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/04/2009 |
| Last Update Date | 11/07/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.