Healthcare Provider Details
I. General information
NPI: 1811047400
Provider Name (Legal Business Name): SPELIOS AND ASSOCIATES SNELLVILLE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2341 HENRY CLOWER BLVD SUITE A
SNELLVILLE GA
30078-7420
US
IV. Provider business mailing address
2341 HENRY CLOWER BLVD SUITE A
SNELLVILLE GA
30078-7420
US
V. Phone/Fax
- Phone: 770-736-0099
- Fax: 770-736-7971
- Phone: 770-736-0099
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
ANDREW
LITTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 678-879-1177