Spackman, Thomas N

Spackman, Thomas N is an individual health care provider with primary practice located at 4500 San Pablo Rd S , Jacksonville FL 32224-1865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Spackman, Thomas N can be contacted via phone (904) 953-2000.

Contact Information

Primary practice address
4500 San Pablo Rd S Jacksonville FL 32224-1865
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 24521 Minnesota
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME73508 Florida

Profile Details

NPI number 1316927718
LBN Legal business name Spackman, Thomas N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Mar 29th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316927718 NPPES
Minnesota MEDICAID 749514500
Minnesota MEDICAID 000699600

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