Provider Demographics
NPI:1043421597
Name:SPITLER, BRANDI (DO)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:
Last Name:SPITLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-6200
Mailing Address - Fax:
Practice Address - Street 1:4766 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1613
Practice Address - Country:US
Practice Address - Phone:614-722-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.002241208000000X
PW34009436208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2956967Medicaid