Provider Demographics
NPI:1205992070
Name:SPANGLER, WILLIAM CRAIG (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:SPANGLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX T
Mailing Address - Street 2:2 KENWOOD STREET
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012
Mailing Address - Country:US
Mailing Address - Phone:704-825-5322
Mailing Address - Fax:704-825-5318
Practice Address - Street 1:2 KENWOOD STREET
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012
Practice Address - Country:US
Practice Address - Phone:704-825-5322
Practice Address - Fax:704-825-5318
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0846152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909855Medicaid
NC8909855Medicaid
246248Medicare ID - Type Unspecified