Individual
MR. JEFFREY JAMES SPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1918 RANDOLPH RD STE 400, CHARLOTTE, NC 28207-1196
(704) 384-9437
(704) 384-9440
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9437
(704) 384-9440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05848
NC
363AS0400X
Surgical Physician Assistant
PA08818
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407271026
—
NC
05
—
2394PA
—
SC
Enumeration date
02/19/2014
Last updated
12/20/2023
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