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Individual

DR. JUSTIN KUHNS SPOONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
230 CANAL BLVD STE 2, PONTE VEDRA BEACH, FL 32082-3745
(904) 280-6701
(904) 280-6702
Mailing address
230 CANAL BLVD STE 2, PONTE VEDRA BEACH, FL 32082-3745
(904) 280-6701
(904) 280-6702

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME115625
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME115625
FL
208VP0014X
Interventional Pain Medicine Physician
ME115625
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0086324100
FL
01
HG956
MEDICARE
FL
Enumeration date
11/21/2007
Last updated
03/07/2023
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