Provider Demographics
NPI:1639588858
Name:SPECTRUM HEALTHCARE PARTNERS, PA
Entity Type:Organization
Organization Name:SPECTRUM HEALTHCARE PARTNERS, PA
Other - Org Name:OA CENTERS FOR ORTHOPAEDICS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WIPFLER
Authorized Official - Suffix:
Authorized Official - Credentials:JD,MBA
Authorized Official - Phone:207-828-2100
Mailing Address - Street 1:33 SEWALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2603
Mailing Address - Country:US
Mailing Address - Phone:207-828-2100
Mailing Address - Fax:296-828-2190
Practice Address - Street 1:33 SEWALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2603
Practice Address - Country:US
Practice Address - Phone:207-828-2100
Practice Address - Fax:296-828-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT1862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty