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Individual

JIMMY A. SPIVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5303 ADAMS ST NE, STE A, COVINGTON, GA 30014-6208
(706) 549-1663
(706) 546-8792
Mailing address
1765 OLD WEST BROAD ST, BLDG 2, STE 200, ATHENS, GA 30606
(706) 549-1663
(706) 546-8792

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
012572
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000143932K
GA
Enumeration date
10/07/2005
Last updated
03/24/2015
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