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Individual

JONATHAN W. SPIVACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
75 PRINGLE WAY STE 401, RENO, NV 89502-1476
(775) 982-5000
(775) 982-2973
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
12472
NV
2084N0400X
Neurology Physician
38942-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11006113
CAQH
05
1497790513
NV
01
P01019331
RAILROAD MEDICARE
NV
Enumeration date
06/20/2006
Last updated
03/15/2018
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