Provider Demographics
NPI:1881674372
Name:SPINDLER, RICHARD EUGENE (PA-C)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EUGENE
Last Name:SPINDLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2698
Mailing Address - Country:US
Mailing Address - Phone:937-208-7240
Mailing Address - Fax:937-208-7242
Practice Address - Street 1:1520 S MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2698
Practice Address - Country:US
Practice Address - Phone:937-208-7240
Practice Address - Fax:937-208-7242
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50001052363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067777Medicaid
OH0067777Medicaid
OHPA10923Medicare PIN
OHPA10922Medicare PIN