Healthcare Provider Details

I. General information

NPI: 1164428314
Provider Name (Legal Business Name): MARK ANDREW SPERING O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7416
US

IV. Provider business mailing address

2337 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7416
US

V. Phone/Fax

Practice location:
  • Phone: 610-867-1182
  • Fax: 610-866-2196
Mailing address:
  • Phone: 610-867-1182
  • Fax: 610-866-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOEG000088
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: