Healthcare Provider Details

I. General information

NPI: 1578952891
Provider Name (Legal Business Name): MR. JONAH MATTHEW SPOERNDLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 HOSPITAL DR STE 4500
DUBLIN OH
43016-9693
US

IV. Provider business mailing address

7450 HOSPITAL DR STE 4500
DUBLIN OH
43016-9693
US

V. Phone/Fax

Practice location:
  • Phone: 614-788-0588
  • Fax: 614-788-0587
Mailing address:
  • Phone: 614-788-0588
  • Fax: 614-788-0587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: