Provider Demographics
NPI:1659517811
Name:SPIVEY, JOHN CASEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CASEY
Last Name:SPIVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3301 E 1ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8674
Mailing Address - Country:US
Mailing Address - Phone:912-537-4411
Mailing Address - Fax:912-538-8485
Practice Address - Street 1:3301 E 1ST ST STE A
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8674
Practice Address - Country:US
Practice Address - Phone:912-537-4411
Practice Address - Fax:912-538-8485
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2017-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA71885207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery