MEDICARE: DR. FRANK W. SPAETH

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	152W00000X	Optometrist	0895	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	019HN	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598831950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. FRANK W. SPAETH

Provider Business Mailing Address
First Line	:	6611 BURLINGTON RD
Second Line	:
City	:	WHITSETT
State	:	NC
Zip	:	27377-9748
Country	:	US
Telephone Number	:	336-449-1333
Fax Number	:	336-449-1348

Provider Business Practice Location Address
First Line	:	6611 BURLINGTON RD
Second Line	:
City	:	WHITSETT
State	:	NC
Zip	:	27377-9748
Country	:	US
Telephone Number	:	336-449-1333
Fax Number	:	336-449-1348

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FRANK WILLIAM SPAETH
Credential	:	O.D.
Telephone Number	:	336-449-1333

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/09/2013

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