Provider Demographics
NPI:1689630741
Name:SPYCHALSKI, JAMES N (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:N
Last Name:SPYCHALSKI
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 1:1212 GARFIELD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3247
Mailing Address - Country:US
Mailing Address - Phone:681-229-3058
Mailing Address - Fax:
Practice Address - Street 1:1212 GARFIELD AVE STE 202
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3247
Practice Address - Country:US
Practice Address - Phone:681-229-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2260995Medicaid
WV1806194000Medicaid
P00067930Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WV1806194000Medicaid
OH2260995Medicaid