MEDICARE: A. DOUGLAS SPITALNY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	748	MN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	748	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568405330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	A. DOUGLAS SPITALNY DPM

Provider Business Mailing Address
First Line	:	PO BOX 2546
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64803-2546
Country	:	US
Telephone Number	:	620-783-4441
Fax Number	:	620-783-4090

Provider Business Practice Location Address
First Line	:	MCXP-CCS-CR
Second Line	:	GENERAL LEONARD WOOD COMMUNITY HOSPITAL
City	:	FT. LEONARD WOOD
State	:	MO
Zip	:	65473-1267
Country	:	US
Telephone Number	:	573-596-1764
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	02/13/2023

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Directions to “ A. DOUGLAS SPITALNY DPM” Practice Location

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