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General NPI Number Information
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NPI Number | 1821091612
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Entity Type | Individual
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Provider Name | EUGENE J. SPIOTTA JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 6005 PARK AVE STE 200
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City | MEMPHIS
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State | TN
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Zip | 38119-5212
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Country | US
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Telephone | 901-761-2100
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Fax | 901-682-9351
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Provider Business Mailing Address
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Address Line | 6005 PARK AVE STE 200
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City | MEMPHIS
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State | TN
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Zip | 38119-5212
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Country | US
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Telephone | 901-761-2100
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Fax | 901-682-9351
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD008432
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License Number State | TN
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