Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC-002046L | PA |
Y | 222Z00000X | Podiatrist | SC-002046L | PA |
N | 213ES0131X | Foot Surgery | SC002046L | PA |
NPI | 1023082435 |
---|---|
Provider Name | Dr. Richard Lee Spinner |
First Address | Stroudsburg, PA 18360 |
Second Address | Stroudsburg, PA 18360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 07/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07632072 | (05) | PA |
O93120 | (02) | PA |