Individual
DR. JAMES J SPADARO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 308-1301
(573) 202-2480
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 308-1301
(573) 202-2480
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
R9324
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10372
BC/BS ID#
—
01
—
145792
HEALTHLINK ID#
—
05
—
202587614
—
MO
05
—
202587622
—
MO
01
—
2500043
UHC ID#
—
01
—
4040796
AETNA ID#
—
01
—
43-1571021
TAX ID#
—
01
—
5512255
CIGNA ID#
—
01
—
8712
GHP ID#
—
Enumeration date
07/21/2005
Last updated
03/24/2021
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