Provider Demographics
NPI:1942401583
Name:SPOERKE, NICHOLAS JON (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JON
Last Name:SPOERKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:75 PRINGLE WAY
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1475
Mailing Address - Country:US
Mailing Address - Phone:775-323-7500
Mailing Address - Fax:775-789-9208
Practice Address - Street 1:75 PRINGLE WAY
Practice Address - Street 2:SUITE 1002
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1475
Practice Address - Country:US
Practice Address - Phone:775-323-7500
Practice Address - Fax:775-789-9208
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2016-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV14314208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGH029ZMedicare UPIN