Active NPI
Earle W Spohn Jr., DO
- Surgery Physician
- Detroit, MI
National Provider Identifier
1083625032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5101005851
- Practice address
- 7815 East Jefferson
Suite 3D
Detroit, MI 48214 - Phone
- (313) 499-4862
- Fax
- (313) 499-4865
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5101005851 | MI | Primary |
Addresses
Primary practice location
7815 East Jefferson
Suite 3D
Detroit, MI 48214
Mailing address
27 Balfour Dr
Bloomfield Hills, MI 48304
Phone (248) 646-8411
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0288229095 | Other | MI | BCBS |
| 1561975 | Medicaid | MI | |
| 8822909 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1083625032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 BALFOUR DR",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "48304",
"telephone_number": "248-646-8411",
"fax_number": "248-646-2296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7815 EAST JEFFERSON",
"address_2": "SUITE 3D",
"city": "DETROIT",
"state": "MI",
"postal_code": "48214",
"telephone_number": "313-499-4862",
"fax_number": "313-499-4865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOHN",
"first_name": "EARLE",
"middle_name": "W",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "5101005851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0288229095",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1561975",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8822909",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.