MEDICARE: SPECTRUM MEDICAL CARE

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

General Provider Information

NPI Number	:	1942383195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM MEDICAL CARE

Provider Business Mailing Address
First Line	:	5107 MOORES MILL RD
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811-1007
Country	:	US
Telephone Number	:	256-851-7166
Fax Number	:	256-851-7194

Provider Business Practice Location Address
First Line	:	5107 MOORES MILL RD
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811-1007
Country	:	US
Telephone Number	:	256-851-7166
Fax Number	:	256-851-7194

Authorized Official
Title or Position	:	BILLING MGR
Name	:	MONICA COPELAND
Credential	:
Telephone Number	:	256-851-7166

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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Directions to “SPECTRUM MEDICAL CARE ” Practice Location

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