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General NPI Number Information
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NPI Number | 1811941008
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Entity Type | Organization
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Legal Business Name | STEVEN D. SPADY
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 509 MEMORIAL DR SUITE 2
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City | MANCHESTER
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State | KY
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Zip | 40962-6195
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Country | US
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Telephone | 606-598-8813
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Fax | 606-599-0983
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Provider Business Mailing Address
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Address Line | 509 MEMORIAL DR SUITE 2
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City | MANCHESTER
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State | KY
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Zip | 40962-6195
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Country | US
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Telephone | 606-598-8813
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Fax | 606-599-0983
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. STEVEN D SPADY
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Credential | D.O.
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Telephone | 606-598-8813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 900134
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License Number State | KY
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