Provider Demographics
NPI:1134225410
Name:JEAN G SPAULDING MD
Entity type:Organization
Organization Name:JEAN G SPAULDING MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:GAILLARD
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-668-3326
Mailing Address - Street 1:301 RUSSO VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:919-650-1198
Mailing Address - Fax:919-668-3323
Practice Address - Street 1:2400 PRATT STREET
Practice Address - Street 2:SUITE 1500 FIRST FLOOR
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-668-3326
Practice Address - Fax:919-668-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty