Provider Demographics
NPI:1669460267
Name:SPENNINGSBY, JAMES RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RAYMOND
Last Name:SPENNINGSBY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1542 GOLF COURSE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3555
Mailing Address - Country:US
Mailing Address - Phone:218-326-3433
Mailing Address - Fax:218-326-3435
Practice Address - Street 1:1542 GOLF COURSE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3555
Practice Address - Country:US
Practice Address - Phone:218-326-3433
Practice Address - Fax:218-326-3435
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN21647207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0008-0002634OtherMEDICA GRAND RAPIDS
0817780OtherMEDICA
180006396OtherTRAVELERS MC
0E085OtherBLUE SHIELD OF MN
ND16523OtherMEDICAL ASSISTANCE
MN1669460267OtherBCBS MN NPI
MN0008-0002636OtherMEDICA HIBBING
MN1669460267OtherPREFERRED ONE
MN180001615OtherPTAN
19012SPOtherBLUE SHIELD OF MN
ND23230OtherNORIDIAN
29972OtherHEALTH PARTNERS
MN1989OtherNORIDIAN
MN432793400Medicaid
986521006415OtherPREFERRED ONE
MN1669460267OtherHEALTHPARTNERS
MN1669460267OtherUCARE
HP50071OtherHEALTH PARTNERS
29972OtherHEALTH PARTNERS
MN432793400Medicaid
HP50071OtherHEALTH PARTNERS