Individual
DR. ANTHONY ROLAND SPEDALE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 WESTSIDE DR, DOTHAN, AL 36303-1928
(334) 793-5074
(334) 793-6460
Mailing address
3113 WESLEY WAY STE 1, DOTHAN, AL 36305-2004
(334) 699-5123
(334) 699-5125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22862
AL
207R00000X
Internal Medicine Physician
24418
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051550636
—
AL
01
—
110221409
RAILROAD MEDICARE
—
Enumeration date
05/24/2005
Last updated
11/06/2020
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