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General NPI Number Information
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NPI Number | 1912918897
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Entity Type | Individual
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Provider Name | JOHN EDWARD SPAULDING JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 POWELL ST SUITE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1826
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Country | US
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Telephone | 510-350-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 N DECATUR RD
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City | DECATUR
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State | GA
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Zip | 30033-5918
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Country | US
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Telephone | 404-501-1849
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 42448
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License Number State | GA
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