Healthcare Provider Details

I. General information

NPI: 1518940113
Provider Name (Legal Business Name): CRAIG A SPOERING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 NORTH 12TH STREET
GRAND JUNCTION CO
81506-5517
US

IV. Provider business mailing address

PO BOX 10700
GRAND JUNCTION CO
81502-5517
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-5437
  • Fax: 970-243-7792
Mailing address:
  • Phone: 970-243-5437
  • Fax: 970-243-7792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number22920
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: