Basic Information
Provider Information
NPI: 1841331279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPOONER
FirstName: JOHN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2011 MURPHY AVE
Address2: SUITE 301
City: NASHVILLE
State: TN
PostalCode: 372032023
CountryCode: US
TelephoneNumber: 6153279543
FaxNumber: 6153417583
Practice Location
Address1: 2011 MURPHY AVE
Address2: SUITE 301
City: NASHVILLE
State: TN
PostalCode: 372032023
CountryCode: US
TelephoneNumber: 6153279543
FaxNumber: 6153417583
Other Information
ProviderEnumerationDate: 02/09/2007
LastUpdateDate: 12/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X42735TNY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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