Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 37237 | IA |
NPI | 1134285836 |
---|---|
Provider Name | Dr. Shawn Spooner |
First Address | Urbandale, IA 50322-4201 |
Second Address | Urbandale, IA 50322-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 27/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1134285836 | (05) | IA |