Provider Demographics
NPI:1063604486
Name:SPAHR INC
Entity type:Organization
Organization Name:SPAHR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPAHR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:641-672-9930
Mailing Address - Street 1:1417 A AVE E
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-4280
Mailing Address - Country:US
Mailing Address - Phone:641-672-9930
Mailing Address - Fax:641-672-9932
Practice Address - Street 1:1417 A AVE E
Practice Address - Street 2:SUITE 300
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-4280
Practice Address - Country:US
Practice Address - Phone:641-672-9930
Practice Address - Fax:641-672-9932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2102491Medicaid
IA2102491Medicaid