Organization
MARK SPIVEY ORTHOPEDIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES M SPIVEY MD (OWNER)
(912) 537-4411
Entity
Organization
Contact information
Practice address
247 S MAIN ST, REIDSVILLE, GA 30453-4605
(912) 537-4411
(912) 538-8485
Mailing address
3301 E 1ST ST, STE A, VIDALIA, GA 30474-8674
(912) 537-4411
(912) 538-8485
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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