Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 025045 | GA |
NPI | 1477623098 |
---|---|
Provider Name | Paul Victor Spiegl SR. |
First Address | Atlanta, GA 30342-1731 |
Second Address | Atlanta, GA 30342-1731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 01/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
58-1646346 | TAX ID (01) | GA |
D30881 | (02) | GA |