Provider Demographics
NPI:1669416889
Name:SPINZIG, BRUCE D (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:D
Last Name:SPINZIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 TYSON AVE
Mailing Address - Street 2:POB 1030
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4544
Mailing Address - Country:US
Mailing Address - Phone:731-644-8535
Mailing Address - Fax:731-642-9588
Practice Address - Street 1:301 TYSON AVE
Practice Address - Street 2:POB 1030
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4544
Practice Address - Country:US
Practice Address - Phone:731-644-8535
Practice Address - Fax:731-642-9588
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44297208M00000X, 207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN014072OtherSIHO
TN1511587Medicaid
TNQ003319Medicaid
TN1511587Medicaid
IN014072OtherSIHO
TN103I116454Medicare PIN