Provider Demographics
NPI:1013906312
Name:PHYSICIANS OF LONDON INC.
Entity type:Organization
Organization Name:PHYSICIANS OF LONDON INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-852-6000
Mailing Address - Street 1:54 W HIGH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1075
Mailing Address - Country:US
Mailing Address - Phone:740-852-6000
Mailing Address - Fax:740-852-7955
Practice Address - Street 1:54 W HIGH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1075
Practice Address - Country:US
Practice Address - Phone:740-852-6000
Practice Address - Fax:740-852-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2253234Medicaid
OH2253234Medicaid