Healthcare Provider Details

I. General information

NPI: 1831501907
Provider Name (Legal Business Name): JOSHUA ROBERT SPICER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE
JACKSON MI
49201
US

IV. Provider business mailing address

1315 HOSPITAL DR
ST JOHNSBURY VT
05819-9210
US

V. Phone/Fax

Practice location:
  • Phone: 517-788-4800
  • Fax: 517-817-7050
Mailing address:
  • Phone: 802-748-8141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number33054
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number032.0133792
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: