Provider Demographics
NPI:1790017069
Name:SPIEGEL, ROBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:SPIEGEL
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:HCR 61 BOX 30
Mailing Address - Street 2:JCT US HWY 160 & NR 35 - RED MESA
Mailing Address - City:TEECNOSPOS
Mailing Address - State:AZ
Mailing Address - Zip Code:86514
Mailing Address - Country:US
Mailing Address - Phone:928-656-5000
Mailing Address - Fax:928-656-5164
Practice Address - Street 1:HCR 61 BOX 30
Practice Address - Street 2:JCT US HWY 160 & NR 35 - RED MESA
Practice Address - City:TEECNOSPOS
Practice Address - State:AZ
Practice Address - Zip Code:86514
Practice Address - Country:US
Practice Address - Phone:928-656-5000
Practice Address - Fax:928-656-5164
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45341207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM70905266Medicaid
AZ501990Medicaid
CO30508568Medicaid
AZ501990Medicaid
CO30508568Medicaid