Provider Demographics
NPI:1467851956
Name:ROBERT T SPALDING JR DPM AREA PODIATRY CENTERS
Entity Type:Organization
Organization Name:ROBERT T SPALDING JR DPM AREA PODIATRY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TUCKER
Authorized Official - Last Name:SPALDING
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:423-756-3668
Mailing Address - Street 1:1225 TAFT HWY
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-3251
Mailing Address - Country:US
Mailing Address - Phone:423-756-3668
Mailing Address - Fax:423-886-1142
Practice Address - Street 1:1225 TAFT HWY
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-3251
Practice Address - Country:US
Practice Address - Phone:423-756-3668
Practice Address - Fax:423-886-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN028213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty