Healthcare Provider Details

I. General information

NPI: 1023082435
Provider Name (Legal Business Name): RICHARD LEE SPINNER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N. 5TH STREET
STROUDSBURG PA
18360
US

IV. Provider business mailing address

1101 N. 5TH STREET
STROUDSBURG PA
18360
US

V. Phone/Fax

Practice location:
  • Phone: 570-424-6928
  • Fax: 570-421-5472
Mailing address:
  • Phone: 570-424-6928
  • Fax: 570-421-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC-002046L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC002046L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: