Provider Demographics
NPI:1427197474
Name:SPIRNAK, JOSEPH P (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:SPIRNAK
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:5319 HOAG DR
Practice Address - Street 2:SUITE 130
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1494
Practice Address - Country:US
Practice Address - Phone:440-930-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-2484-S2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH450518980002OtherMMOH
OH000000313284OtherANTHEM
OH611915100OtherUS DEPT OF LABOIR
OH2154350Medicaid
OHP00069369OtherRR MEDICARE
OH450518980027OtherCARESOURCE