NPI Code Details Logo

NPI 1093808305

NPI 1093808305 : DR. MARK ALAN SPIKER : PENNSBORO, WV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1093808305
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DR. MARK ALAN SPIKER
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/02/2006
-----------------------------------------------------
    Last Update Date     |    03/07/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    304 MASONIC AVE 
-----------------------------------------------------
    City                 |    PENNSBORO
-----------------------------------------------------
    State                |    WV
-----------------------------------------------------
    Zip                  |    26415
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    304-659-2585
-----------------------------------------------------
    Fax                  |    304-659-2593
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    304 MASONIC AVE 
-----------------------------------------------------
    City                 |    PENNSBORO
-----------------------------------------------------
    State                |    WV
-----------------------------------------------------
    Zip                  |    26415
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    304-659-2585
-----------------------------------------------------
    Fax                  |    304-659-2593
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    122300000X
-----------------------------------------------------
    Taxonomy Name        |    Dentist
-----------------------------------------------------
    License Number       |    2413
-----------------------------------------------------
    License Number State |    WV
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.