Healthcare Provider Details

I. General information

NPI: 1194932574
Provider Name (Legal Business Name): TAMMY DENISE SPIGHT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 5TH AVE
PITTSBURGH PA
15213-2584
US

IV. Provider business mailing address

5559 HOBART ST APARTMENT #19
PITTSBURGH PA
15217-1932
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5055
  • Fax: 412-692-7580
Mailing address:
  • Phone: 412-421-1816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA001489-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: