SPENCER COREY SOUTHERLAND


Address: Seal Team 2, Unit 60003, Fpo, AE 09501-4633
Phone: 3602860972

SPENCER COREY SOUTHERLAND (NPI# 1922359702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922359702
Entity Type Individual
Full Name SPENCER COREY SOUTHERLAND
Credential IDC
Practice Address Seal Team 2
Unit 60003
Fpo
AE 09501-4633
Practice Telephone 3602860972
Enumeration Date 2012-09-20
Last Update Date 2012-09-20
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171000000X Military Health Care Provider Other Service Providers

Office Location

Street Address SEAL TEAM 2
UNIT 60003
City FPO
State AE
Zip Code 09501-4633

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Taxonomy Information

Taxonomy Code 171000000X
Grouping Other Service Providers
Classification Military Health Care Provider

Taxonomy Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Notes: [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215306675 Bryan Lopez Military Health Care Provider Psc 455 Box 182, Medical Department, Navspecwaunit One, Fpo, AP 96540-1182 2015-09-16
1013385533 Yomaira Maritza Gonzalez Military Health Care Provider Psc 475 Box 1345, Fpo, AP 96350-9998 2015-09-15
1750763637 Kathleen R Montanez Military Health Care Provider Naval Hospital Guam Psc 455, Fpo, AP 96540 2015-06-26
1164827135 Mark Steven Little Military Health Care Provider 3d Marine Division, Unit 35801, Fpo, AP 96382-5801 2014-11-03
1598164592 Jami Erickson Military Health Care Provider Uss Dewey, Ddg 105, Fpo, AP 96663-1303 2014-08-15
1609164946 Adam Alma Reel Military Health Care Provider 3d Recon Bn, Unit 36180, Fpo, AP 96602-6180 2011-07-20
1972742773 8carla T Yballe Military Health Care Provider Bldg. 9497 Kab Psc 4821, Fpo, AP 96362 2009-02-18
1528210374 John Wesley Huckleberry II Military Health Care Provider Unit 100236 Drawer 2703, Uss Dwight D Eisenhower Cvn 69, Fpo, AE 09532-3627 2008-10-10
1851561518 Christopher Michael Brown Military Health Care Provider Uss Tripoli (lha-7), Medical Department, Fpo, AP 99765 2008-03-09
1376739722 Gary B. Hoyt Military Health Care Provider Psc 482 Box 2577, Fpo, AP 96362 2007-09-19
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City FPO
Zip Code 09501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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