Provider Demographics
NPI:1457530487
Name:ROBERT G. SPRATT, M.D. INC.
Entity Type:Organization
Organization Name:ROBERT G. SPRATT, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SPRATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-788-4097
Mailing Address - Street 1:231 E MIDLOTHIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-1947
Mailing Address - Country:US
Mailing Address - Phone:300-788-4097
Mailing Address - Fax:330-788-4061
Practice Address - Street 1:231 E MIDLOTHIAN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1947
Practice Address - Country:US
Practice Address - Phone:300-788-4097
Practice Address - Fax:330-788-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-9573S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9200101OtherPTAN
OH2342996Medicaid
OH000000126547OtherANTHEM BLUE CROSS
OHDN5046OtherRAILROAD MEDICARE GROUP
OH080004716OtherRAILROAD MEDICARE
OH9200101OtherMEDICARE GROUP
OH9200101Medicare PIN
OH9200101OtherMEDICARE GROUP