Provider Demographics
NPI:1255482212
Name:SPELIOS AND ASSOCIATES PA III
Entity Type:Organization
Organization Name:SPELIOS AND ASSOCIATES PA III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-879-1177
Mailing Address - Street 1:9912 MONROE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5416
Mailing Address - Country:US
Mailing Address - Phone:704-814-8881
Mailing Address - Fax:
Practice Address - Street 1:9912 MONROE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5416
Practice Address - Country:US
Practice Address - Phone:704-814-8881
Practice Address - Fax:704-814-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service