Jack Anthony Spatafore in Bridgeport - Specialist
Jack Anthony Spatafore - NPI 1093711657
Jack Anthony Spatafore is a Specialist in Bridgeport, . Jack Anthony Spatafore practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack Anthony Spatafore is 1093711657. The last update date is 2009-03-25.
Jack Anthony Spatafore's current location address is 306 W Main St, Bridgeport, . You can contact this provider via phone number 3048423137 and fax number 3048423138. The mailing address for Jack Anthony Spatafore is 306 W Main St, Bridgeport, . To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Anthony Spatafore |
|---|---|
| Address | 306 W Main St, Bridgeport, |
| Phone Number | 3048423137 |
| Fax Number | 3048423138 |
| Sole Proprietor | N |
| Credentials | DPT/MS |
NPI Number Detail
| NPI Number | 1093711657 |
|---|---|
| Provider Enumeration Date | 2005-06-28 |
| Last Updated Date | 2009-03-25 |
Provider Mailing Address Detail
| Address | 306 W Main St |
|---|---|
| City | Bridgeport |
| State | (WV) |
| Post Code | 263301751 |
| Phone Number | 3048423137 |
| Fax Number | 3048423138 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 2038 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1071873100 | WV | WV WORKERS' COMPENSATION | |
| 1382862 | WV | UMWA | |
| 7305012-001 | WV | -- | |
| WV51916B | WV | HEALTH PLAN | |
| 701615 | WV | AETNA | |
| 650023875 | WV | RAILROAD MEDICARE | |
| 10718731004 | WV | BLUE CROSS | |
| 135810 | WV | HEALTH ASSURANCE | |
| 398789 | WV | OPTIMUM CHOICE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jack Anthony Spatafore by the Centers for Medicare & Medicaid Services?
The Jack Anthony Spatafore has been issued the NPI (National Provider Identifier) 1093711657, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Jack Anthony Spatafore's facilities are situated?
The facilities of Jack Anthony Spatafore are physically located at the following address: 306 W Main St, Bridgeport, WV, 263301751.
What is Jack Anthony Spatafore's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jack Anthony Spatafore is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did the Jack Anthony Spatafore receive its 1093711657 assignment from the Centers for Medicare & Medicaid Services?
The Jack Anthony Spatafore was assigned its 1093711657 by the Centers for Medicare & Medicaid Services on 2005-06-28.
As of what date was the information pertaining to Jack Anthony Spatafore, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jack Anthony Spatafore, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-03-25.