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1184882979 NPI number — TONY WILLIAM SPATZ M.D.

NPI Number: 1184882979
Health Care Provider/Practitioner: TONY WILLIAM SPATZ M.D.

Information about “1184882979” NPI (TONY WILLIAM SPATZ M.D.) exists in 1184882979 in HTML format HTML  |  1184882979 in plain Text format TXT  |  1184882979 in PDF (Portable Document Format) PDF  |  1184882979 in an XML format XML  formats.

NPI Number : 1184882979 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184882979",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPATZ",
    "FirstName": "TONY",
    "MiddleName": "WILLIAM",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1489 DEER RUN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT GIBSON",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74434-9351",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "300 ROCKEFELLER DR",
    "SecondLinePracticeLocationAddress": "DEPARTMENT OF ANESTHESIOLOGY",
    "PracticeLocationAddressCityName": "MUSKOGEE",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74401-5075",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-684-5501",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/28/2008",
    "LastUpdateDate": "11/15/2012",
    "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": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "29129",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "P0502",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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