MEDICARE: DR. OSCAR SMITH SPIVEY JR. MD

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	208800000X	Urology Physician	MD12960	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326146911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSCAR SMITH SPIVEY JR. MD

Provider Business Mailing Address
First Line	:	1550 SPARTA ST
Second Line	:	SUITE 1
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1315
Country	:	US
Telephone Number	:	931-473-1526
Fax Number	:	931-473-1528

Provider Business Practice Location Address
First Line	:	1550 SPARTA ST
Second Line	:	SUITE 1
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1315
Country	:	US
Telephone Number	:	931-473-1526
Fax Number	:	931-473-1528

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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