Provider Demographics
NPI:1275600587
Name:SPELLMAN, DOUGLAS F (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:F
Last Name:SPELLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-280-8100
Mailing Address - Fax:402-280-8103
Practice Address - Street 1:14092 BOYS TOWN HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010
Practice Address - Country:US
Practice Address - Phone:531-355-1449
Practice Address - Fax:531-355-0001
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE181352084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE73224Medicare UPIN