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General NPI Number Information
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NPI Number | 1205897402
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Entity Type | Individual
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Provider Name | PHILLIP R SPANGLER MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 2 CHATEAU LN
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1626
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Country | US
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Telephone | 304-736-9662
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Fax |
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Provider Business Mailing Address
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Address Line | 97 GREAT TEAYS BLVD STE 6
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City | SCOTT DEPOT
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State | WV
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Zip | 25560-9815
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Country | US
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Telephone | 304-757-6999
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Fax | 304-201-5019
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20915
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License Number State | WV
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