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NPI Code Detail

MEDICARE: SP MEDICAL SERVICES PC

MEDICARE: SP MEDICAL SERVICES PC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1609503218
Entity Type Code : Organization
Provider Name (Legal Business Name) : SP MEDICAL SERVICES PC
Provider Business Mailing Address
First Line : 481 WYTHE AVE STE 102
Second Line :
City : BROOKLYN
State : NY
Zip : 11249-6184
Country : US
Telephone Number : 347-534-8640
Fax Number :
Provider Business Practice Location Address
First Line : 300 S SPRING ST STE 300
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72201-2419
Country : US
Telephone Number : 347-534-8640
Fax Number :
Authorized Official
Title or Position : OWNER
Name : STEVEN W POWELL
Credential : MD, MPH, CPE, FAPA
Telephone Number : 603-828-3759
Provider Enumeration Date : 08/03/2022
Last Update Date : 02/27/2023

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Directions to “SP MEDICAL SERVICES PC ” Practice Location

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