Healthcare Provider Details

I. General information

NPI: 1932845427
Provider Name (Legal Business Name): THOMAS MATTHEW SPANGLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CRAMER CREEK CT
DUBLIN OH
43017-2586
US

IV. Provider business mailing address

299 CRAMER CREEK CT
DUBLIN OH
43017-2586
US

V. Phone/Fax

Practice location:
  • Phone: 614-889-5722
  • Fax:
Mailing address:
  • Phone: 614-889-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2309683
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: