Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | MD427308 | PA |
Y | 207T00000X | Neurosurgeon | ME136438 | FL |
N | 207T00000X | Neurosurgeon | N4123 | TX |
NPI | 1114065646 |
---|---|
Provider Name | Theodore James Spinks |
First Address | Lutz, FL 33558-5255 |
Second Address | Lutz, FL 33558-5255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 03/11/2020 |