Provider Demographics
NPI:1114065646
Name:SPINKS, THEODORE JAMES (MD)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:JAMES
Last Name:SPINKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16506 POINTE VILLAGE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5255
Mailing Address - Country:US
Mailing Address - Phone:813-336-4461
Mailing Address - Fax:813-336-4466
Practice Address - Street 1:16506 POINTE VILLAGE DR STE 107
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5255
Practice Address - Country:US
Practice Address - Phone:813-336-4461
Practice Address - Fax:813-336-4466
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427308207T00000X
TXN4123207T00000X
FLME136438207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery