Individual
CHARLES M SPIVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3301 FIRST STREET EAST, SUITE A, VIDALIA, GA 30474
(912) 537-4411
(912) 538-8485
Mailing address
3301 FIRST STREET EAST, SUITE A, VIDALIA, GA 30474
(912) 537-4411
(912) 538-8485
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
047846
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501468518E
—
GA
Enumeration date
09/06/2005
Last updated
07/27/2010
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