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1184833584 NPI number — WILLIAM C SPANOS M.D.

NPI Number: 1184833584
Health Care Provider/Practitioner: WILLIAM C SPANOS M.D.

Information about “1184833584” NPI (WILLIAM C SPANOS M.D.) exists in 1184833584 in HTML format HTML  |  1184833584 in plain Text format TXT  |  1184833584 in PDF (Portable Document Format) PDF  |  1184833584 in an XML format XML  formats.

NPI Number : 1184833584 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184833584",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPANOS",
    "FirstName": "WILLIAM",
    "MiddleName": "C",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 5074",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SIOUX FALLS",
    "MailingAddressStateName": "SD",
    "MailingAddressPostalCode": "57117-5074",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "605-328-8200",
    "MailingAddressFaxNumber": "605-328-8201",
    "FirstLinePracticeLocationAddress": "1310 W 22ND ST",
    "SecondLinePracticeLocationAddress": "SANFORD ENT",
    "PracticeLocationAddressCityName": "SIOUX FALLS",
    "PracticeLocationAddressStateName": "SD",
    "PracticeLocationAddressPostalCode": "57105-1501",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "605-328-8200",
    "PracticeLocationAddressFaxNumber": "605-328-8201",
    "EnumerationDate": "05/22/2007",
    "LastUpdateDate": "04/21/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Y00000X",
          "TaxonomyName": "Otolaryngology Physician",
          "LicenseNumber": "34781",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Y00000X",
          "TaxonomyName": "Otolaryngology Physician",
          "LicenseNumber": "7326",
          "LicenseNumberStateCode": "SD",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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