Provider Demographics
NPI:1114948122
Name:SPITALNY, NEIL HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:HOWARD
Last Name:SPITALNY
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 1:5022 OLD GODSEY LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-6600
Mailing Address - Country:US
Mailing Address - Phone:423-870-4999
Mailing Address - Fax:423-870-1985
Practice Address - Street 1:5022 OLD GODSEY LN
Practice Address - Street 2:SUITE 2
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-6600
Practice Address - Country:US
Practice Address - Phone:423-870-4999
Practice Address - Fax:423-870-1985
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD15735207X00000X
GA051388207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00949451AMedicaid
TN1537414OtherUMWA HEALTH
TN4139453OtherAETNA
TN100020710OtherHEALTH STRATEGIES
TN3012938OtherACCESS MED PLUS
TN621753676OtherCIGNA
TNTN0101OtherJOHN DEERE HEALTH
TN1502623Medicaid
TN621753676OtherUNITED HEALTH CARE
TN3103052OtherBLUE CROSS BLUE SHIELD
KY373943600OtherOWCP KENTUCKY
TNA97695Medicare UPIN
TN1502623Medicaid
TN20035099Medicare PIN
KY373943600OtherOWCP KENTUCKY