Provider Demographics
NPI:1952345241
Name:ISPIRESCU, JEFFREY SORIN (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SORIN
Last Name:ISPIRESCU
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 1:1327 SUPERIOR ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1735
Mailing Address - Country:US
Mailing Address - Phone:208-263-9757
Mailing Address - Fax:208-965-8128
Practice Address - Street 1:1327 SUPERIOR ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1735
Practice Address - Country:US
Practice Address - Phone:208-263-9757
Practice Address - Fax:208-965-8128
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM9912207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDM9912OtherSTATE MEDICAL LICENSE
CAA74798OtherMEDICAL LICENSE
CA00A747980Medicaid
H98319Medicare UPIN
CAWA74798AMedicare PIN