Healthcare Provider Details

I. General information

NPI: 1649243049
Provider Name (Legal Business Name): SETH GERARD SPOTNITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL CENTER DR STE 402
GADSDEN AL
35903
US

IV. Provider business mailing address

100 MEDICAL CENTER DR STE 402
GADSDEN AL
35903
US

V. Phone/Fax

Practice location:
  • Phone: 256-492-3571
  • Fax: 256-494-5028
Mailing address:
  • Phone: 256-492-3571
  • Fax: 256-494-5028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number11414
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number11414
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: