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NPI Code Detail

MEDICARE: DR. LARRYL C SPEARMON M.D.

MEDICARE: DR. LARRYL C SPEARMON M.D.
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
1208000000XPediatrics Physician42272TN
2208000000XPediatrics Physician20038MS

Other Identifiers

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

General Provider Information

NPI Number : 1639350408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRYL C SPEARMON M.D.
Provider Business Mailing Address
First Line : 711 MAIN ST
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3605
Country : US
Telephone Number : 615-620-8647
Fax Number : 615-515-5773
Provider Business Practice Location Address
First Line : 617 S 8TH ST
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3819
Country : US
Telephone Number : 615-620-8647
Fax Number : 615-515-5773
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2007
Last Update Date : 07/01/2015

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