Jack P Spaniol in Bloomington - Family Medicine
Jack P Spaniol - NPI 1356379184
Jack P Spaniol is a Family Medicine in Bloomington, Illinois. Jack P Spaniol practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Jack P Spaniol is 1356379184. The last update date is 2011-03-31.
Jack P Spaniol's current location address is 308 Saint Joseph Dr, Bloomington, Illinois. You can contact this provider via phone number 3096635050 and fax number 3096623401. The mailing address for Jack P Spaniol is 308 Saint Joseph Dr, Bloomington, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack P Spaniol |
|---|---|
| Address | 308 Saint Joseph Dr, Bloomington, Illinois |
| Phone Number | 3096635050 |
| Fax Number | 3096623401 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1356379184 |
|---|---|
| Provider Enumeration Date | 2006-06-29 |
| Last Updated Date | 2011-03-31 |
Provider Mailing Address Detail
| Address | 308 Saint Joseph Dr |
|---|---|
| City | Bloomington |
| State | Illinois (IL) |
| Post Code | 617013506 |
| Phone Number | 3096635050 |
| Fax Number | 3096623401 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 036-07300 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36073000 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jack P Spaniol by the Centers for Medicare & Medicaid Services?
The Jack P Spaniol has been issued the NPI (National Provider Identifier) 1356379184 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Jack P Spaniol?
The Jack P Spaniol is physically situated at 308 Saint Joseph Dr, in the city of Bloomington, state of IL, with the postal code 617013506.
What is Jack P Spaniol's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jack P Spaniol is Family Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1356379184 to Jack P Spaniol?
The Centers for Medicare & Medicaid Services assigned the 1356379184 to Jack P Spaniol on 2006-06-29.
When was the information related to Jack P Spaniol most recently updated or refreshed?
The details pertaining to the Jack P Spaniol, including its address, specialty, and other relevant information, were last updated or refreshed on 2011-03-31.
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