MEDICARE: DR. ANTHONY SPINA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	R241TAA13	AL
2	152W00000X	Optometrist	OEG002990	PA

General Provider Information

NPI Number	:	1265841266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY SPINA O.D.

Provider Business Mailing Address
First Line	:	2900 E UNIVERSITY DR STE 100
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-7730
Country	:	US
Telephone Number	:	334-539-5931
Fax Number	:	334-539-5390

Provider Business Practice Location Address
First Line	:	2900 E UNIVERSITY DR STE 110
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-7729
Country	:	US
Telephone Number	:	334-539-5391
Fax Number	:	334-539-5390

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	01/24/2022

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