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Individual

PATRICK H SPIVEY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 224-4000
Mailing address
551 MAIN ST, THIRD FLOOR, JOHNSTOWN, PA 15901-2032
(814) 539-5724
(814) 536-7092

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16219
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1510103
TN
05
3014486
TN
05
7100141340
KY
Enumeration date
06/16/2006
Last updated
10/12/2015
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