Provider Demographics
NPI:1730293325
Name:SPOLLEN, JOHN JAMES III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAMES
Last Name:SPOLLEN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:455 MIDLAND ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4207
Mailing Address - Country:US
Mailing Address - Phone:501-257-3160
Mailing Address - Fax:501-257-3164
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:116-F2
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-3478
Practice Address - Fax:501-257-3164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2009-10-29
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Provider Licenses
StateLicense IDTaxonomies
ARE-20732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H998Medicare PIN