Healthcare Provider Details

I. General information

NPI: 1124089065
Provider Name (Legal Business Name): JAMES W SPIRES CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MCNAUGHTEN RD STE 102
COLUMBUS OH
43213
US

IV. Provider business mailing address

PO BOX 182890
COLUMBUS OH
43218
US

V. Phone/Fax

Practice location:
  • Phone: 614-864-6171
  • Fax: 614-864-7674
Mailing address:
  • Phone: 614-864-6171
  • Fax: 614-864-7674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number02932
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: