Provider Demographics
NPI:1316199789
Name:SPAULDING, JOSEPH LEE
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEE
Last Name:SPAULDING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W COOLEY ST
Mailing Address - Street 2:APT 261
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-4751
Mailing Address - Country:US
Mailing Address - Phone:928-242-7534
Mailing Address - Fax:
Practice Address - Street 1:200 W COOLEY ST
Practice Address - Street 2:APT 261
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4751
Practice Address - Country:US
Practice Address - Phone:928-242-7534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care