Provider Demographics
NPI:1952643686
Name:SPADA CREEK EMERGENCY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:SPADA CREEK EMERGENCY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO OF EMCARE
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-382-1530
Mailing Address - Street 1:18167 US HWY 19N
Mailing Address - Street 2:SUITE 650
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764
Mailing Address - Country:US
Mailing Address - Phone:800-507-8874
Mailing Address - Fax:
Practice Address - Street 1:1100 E POPLAR ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4419
Practice Address - Country:US
Practice Address - Phone:479-754-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty