Provider Demographics
NPI:1265841266
Name:SPINA, ANTHONY (OD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:SPINA
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 1:2900 E UNIVERSITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-7730
Mailing Address - Country:US
Mailing Address - Phone:334-539-5931
Mailing Address - Fax:334-539-5390
Practice Address - Street 1:2900 E UNIVERSITY DR STE 110
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-7729
Practice Address - Country:US
Practice Address - Phone:334-539-5391
Practice Address - Fax:334-539-5390
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR241TAA13152W00000X
PAOEG002990152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist