Healthcare Provider Details

I. General information

NPI: 1295724136
Provider Name (Legal Business Name): JOHN PATRICK SPIRNAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 PEARL RD STE 200
MIDDLEBURG HEIGHTS OH
44130-3640
US

IV. Provider business mailing address

104 WOODMONT BLVD STE 500
NASHVILLE TN
37205-2245
US

V. Phone/Fax

Practice location:
  • Phone: 440-845-0900
  • Fax:
Mailing address:
  • Phone: 559-475-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35042212S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: