MEDICARE: DR. FRANK J SPOKAS JR. MD

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	208600000X	Surgery Physician	17031	OR

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801892104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK J SPOKAS JR. MD

Provider Business Mailing Address
First Line	:	3340 E GOLDSTONE WAY
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642
Country	:	US
Telephone Number	:	541-881-2330
Fax Number	:	541-881-2335

Provider Business Practice Location Address
First Line	:	1050 SW 3RD AVE
Second Line	:	STE 2600
City	:	ONTARIO
State	:	OR
Zip	:	97914
Country	:	US
Telephone Number	:	541-881-2330
Fax Number	:	541-881-2335

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/09/2016

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