Provider Demographics
NPI:1154351690
Name:SPANIER, JONATHAN M (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:M
Last Name:SPANIER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:515 STONECREST PKWY
Mailing Address - Street 2:STE 210
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6826
Mailing Address - Country:US
Mailing Address - Phone:615-625-7112
Mailing Address - Fax:615-625-7028
Practice Address - Street 1:330 WALLACE RD
Practice Address - Street 2:STE 109
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-832-5612
Practice Address - Fax:615-331-5133
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-01-21
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Provider Licenses
StateLicense IDTaxonomies
TN40843208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5440833Medicaid
TN5440833Medicaid