Individual
JERRY ALLEN SPIVEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 FOUNDERS ROW, GREENSBORO, GA 30642
(706) 433-0723
(706) 549-7558
Mailing address
PO BOX 80883, ATHENS, GA 30608-0883
(706) 549-8114
(706) 549-7558
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
065063
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
065063
GA
208VP0000X
Pain Medicine Physician
65063
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
65063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003115310B
—
GA
05
—
003115310C
—
GA
05
—
003115310E
—
GA
Enumeration date
07/19/2007
Last updated
02/02/2015
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