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General NPI Number Information
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NPI Number | 1427122712
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Entity Type | Individual
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Provider Name | WILLIAM JOHN SPEARANCE II RPA-C
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 36500 STATE ROUTE 26
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City | CARTHAGE
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State | NY
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Zip | 13619-9506
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Country | US
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Telephone | 315-493-5080
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Fax | 315-493-5082
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Provider Business Mailing Address
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Address Line | 207 SALISBURY STREET
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City | SANDY CREEK
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State | NY
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Zip | 13145-0457
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Country | US
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Telephone |
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 010974
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License Number State | NY
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