Individual
MARK M SPATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1210 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-2954
(706) 322-1717
(706) 322-1718
Mailing address
1210 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-2954
(706) 322-1717
(706) 322-1718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5199
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511I970047
MEDICARE RAILROAD
GA
Enumeration date
10/16/2007
Last updated
03/07/2011
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