Organization
G. SPITZ, M.D., LTD
Active
Other names
SPITZ & BRAXTON, LTD
Organization subpart
No
Provider details
NPI number
Authorized official
LORNELL E HANSEN II MD (OWNER)
(605) 274-0217
Entity
Organization
Contact information
Practice address
1256 WATERFORD DR, SUITE 130, AURORA, IL 60504-4510
(630) 820-2727
(630) 820-7427
Mailing address
1256 WATERFORD DR, SUITE 130, AURORA, IL 60504-4510
(630) 820-2727
(630) 820-7427
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216477
PTAN MEDICARE
—
Enumeration date
08/19/2006
Last updated
04/02/2024
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