Provider Demographics
NPI:1477623098
Name:SPIEGL, PAUL VICTOR SR (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:VICTOR
Last Name:SPIEGL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:VICTOR
Other - Last Name:SPIEGL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 825
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1731
Mailing Address - Country:US
Mailing Address - Phone:404-255-5595
Mailing Address - Fax:404-252-2780
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 825
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1731
Practice Address - Country:US
Practice Address - Phone:404-255-5595
Practice Address - Fax:404-252-2780
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025045207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-1646346OtherTAX ID
GA58-1646346OtherTAX ID