MEDICARE: DR. BRIAN ANDREW SPINKS DO

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	207Q00000X	Family Medicine Physician	0SD12484	PA

General Provider Information

NPI Number	:	1740257575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ANDREW SPINKS DO

Provider Business Mailing Address
First Line	:	312 CHESTNUT ST
Second Line	:	MEDICAL
City	:	ERIE
State	:	PA
Zip	:	16507-1222
Country	:	US
Telephone Number	:	814-347-0017
Fax Number	:	814-347-0019

Provider Business Practice Location Address
First Line	:	312 CHESTNUT ST
Second Line	:	MEDICAL
City	:	ERIE
State	:	PA
Zip	:	16507-1222
Country	:	US
Telephone Number	:	814-347-0017
Fax Number	:	814-347-0019

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	07/08/2007

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