Provider Demographics
NPI:1518130418
Name:SPANG, JEFFREY TWEED (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TWEED
Last Name:SPANG
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:UNIVERSITY OF NORTH CAROLINA HOSPITAL
Mailing Address - Street 2:CB# 7055
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7055
Mailing Address - Country:US
Mailing Address - Phone:919-966-9072
Mailing Address - Fax:919-966-6730
Practice Address - Street 1:UNIVERSITY OF NORTH CAROLINA HOSPITAL
Practice Address - Street 2:CB# 7055
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7055
Practice Address - Country:US
Practice Address - Phone:919-966-9072
Practice Address - Fax:919-966-6730
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPENDING207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine