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Organization

EARLE W. SPOHN JR. D.O. P.C.

Active
Parent organization
EARLE W. SPOHN JR. D.O.
Organization subpart
Yes

Provider details

NPI number
Legal business name
EARLE W. SPOHN JR. D.O.
Authorized official
DR. EARLE W SPOHN JR. DO (PRESIDENT-SOLE PROPRIETOR)
(248) 646-8411
Entity
Organization

Contact information

Practice address
27 BALFOUR DR, BLOOMFIELD HILLS, MI 48304
(248) 646-8411
(248) 646-2296
Mailing address
27 BALFOUR DR, BLOOMFIELD HILLS, MI 48304
(248) 646-8411
(248) 646-2296

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101005851
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0258217514
BCBS
MI
05
1561975
MI
Enumeration date
03/19/2010
Last updated
07/28/2010
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