Healthcare Provider Details

I. General information

NPI: 1932172640
Provider Name (Legal Business Name): HUGH DAVID SPANGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: H. DAVID SPANGLER

II. Dates (important events)

Enumeration Date: 02/12/2006
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 N LEBANON ST STE 305
LEBANON IN
46052-8622
US

IV. Provider business mailing address

2705 N LEBANON ST STE 305
LEBANON IN
46052-8622
US

V. Phone/Fax

Practice location:
  • Phone: 765-485-8700
  • Fax: 765-485-8719
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01028689A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number01028689A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: