Individual
GREGORY C SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
11323 REFLECTION ISLES BLVD, FORT MYERS, FL 33912
(239) 919-6896
(239) 219-6158
Mailing address
11323 REFLECTION ISLES BLVD, FORT MYERS, FL 33912-8919
(239) 919-6896
(239) 219-6158
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004057100
—
FL
01
—
2082528
AETNA USHC
PA
01
—
3014221
CIGNA HEALTHCARE
PA
01
—
302558
HEALTH AMERICA
PA
01
—
413476
BLUE SHIELD
PA
Enumeration date
12/01/2006
Last updated
10/21/2019
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