Frederic C Spector, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Savannah, GA
NPI 1114906286 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1114906286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 484 (GA)
- Practice address
- 352 Commercial Dr
Savannah, GA 31406 - Phone
- (912) 354-3668
- Fax
- (912) 354-0662
- NPI assigned
- Jan 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070131000373 | GA | Practitioner - Podiatry | 9234130428 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 484 | GA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJC Medical Group Inc | Current |
Accepting new patients |
Locations
11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452
352 Commercial Dr
Savannah, GA 31406
Phone (912) 352-3668
602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 484 | GA | Yes |
Addresses
Primary practice location
352 Commercial Dr
Savannah, GA 31406
Mailing address
352 Commercial Dr
Savannah, GA 31406
Phone (912) 354-3668
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000247585A | Medicaid | GA |
Other providers in Savannah, GA
- Mary L Sparkes
- James Lee Spawn
- Lynn Spear
- Douglas Alan Spears
- Adam Walter Specjal
- Spectrum Solutions of Savannah
- Speech Clinic of the Coastal Empire LLC
- Alison Egan Spellman
- Gregory O Spellman
- John Gerard Spellman
All providers in Savannah, GA · Foot & Ankle Surgery Podiatrist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.