Individual
DR. MICHAEL BRYON SPACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 E MONTVUE DR, SUITE 100, MERIDIAN, ID 83642
(208) 855-2900
Mailing address
2835 N TANGLEROSE PL, EAGLE, ID 83616-5796
(952) 239-5080
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
M11335
ID
Other
Enumeration date
04/10/2009
Last updated
07/11/2018
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