Individual
PHILLIP R SPANGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 CHATEAU LN, BARBOURSVILLE, WV 25504-1626
(304) 736-9662
Mailing address
97 GREAT TEAYS BLVD, STE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20915
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006085000
—
WV
05
—
2489883
—
WV
01
—
WV2714D
MEDICARE PTAN
WV
01
—
WV2714E
MEDICARE PTAN
WV
01
—
WV2714F
MEDICARE PTAN
WV
01
—
WV2714G
MEDICARE PTAN
WV
01
—
WV2714H
MEDICARE PTAN
WV
Enumeration date
03/29/2006
Last updated
11/14/2018
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