Healthcare Provider Details

I. General information

NPI: 1790777613
Provider Name (Legal Business Name): RICHARD V SPERA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 11/27/2023
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HUDSON WAY NW STE 2200
HUNTSVILLE AL
35806-2962
US

IV. Provider business mailing address

800 HUDSON WAY NW STE 2200
HUNTSVILLE AL
35806-2962
US

V. Phone/Fax

Practice location:
  • Phone: 256-327-9729
  • Fax: 256-327-0981
Mailing address:
  • Phone: 256-327-9729
  • Fax: 256-327-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21563
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number01079533A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number21563
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: