Healthcare Provider Details

I. General information

NPI: 1689745903
Provider Name (Legal Business Name): WILLIAM A SPOHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 S LIMESTONE ST
SPRINGFIELD OH
45505-1965
US

IV. Provider business mailing address

651 S LIMESTONE ST
SPRINGFIELD OH
45505-1965
US

V. Phone/Fax

Practice location:
  • Phone: 937-324-1111
  • Fax: 937-322-3368
Mailing address:
  • Phone: 937-324-1111
  • Fax: 937-322-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number35047604
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: