Individual
MR. CHRISTOPHER M SPIVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
380 HOSPITAL DR, SUITE 410, MACON, GA 31217
(478) 746-5644
Mailing address
PO BOX 2564, MACON, GA 31203-2565
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN170226
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003120770A
—
GA
05
—
003120770B
—
GA
05
—
003120770C
—
GA
05
—
003120770D
—
GA
01
—
01777918
AMERIGROUP
GA
01
—
580628385
TRICARE
GA
01
—
653947
WELLCARE
GA
01
—
P01078809
RAILROAD MEDICARE
GA
Enumeration date
02/02/2012
Last updated
06/04/2013
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