NPI Code Detail JSON Logo

1073077590 NPI number — SPICER ORTHOPEDICS, LLC

NPI Number: 1073077590
Health Care Provider/Practitioner: SPICER ORTHOPEDICS, LLC

Information about “1073077590” NPI (SPICER ORTHOPEDICS, LLC) exists in 1073077590 in HTML format HTML  |  1073077590 in plain Text format TXT  |  1073077590 in PDF (Portable Document Format) PDF  |  1073077590 in an XML format XML  formats.

NPI Number : 1073077590 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073077590",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SPICER ORTHOPEDICS, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11736 STRASBURG BOLIVAR RD NW APT 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOLIVAR",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44612-8471",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-904-9156",
    "MailingAddressFaxNumber": "330-595-1051",
    "FirstLinePracticeLocationAddress": "11237 FAIROAKS RD NE STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOLIVAR",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44612-8767",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-595-1010",
    "PracticeLocationAddressFaxNumber": "330-595-1051",
    "EnumerationDate": "01/29/2019",
    "LastUpdateDate": "02/16/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SPICER",
    "AuthorizedOfficialFirstName": "KEVIN",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LP, CP, COA",
    "AuthorizedOfficialTelephoneNumber": "330-595-1010",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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