Robert L. Spray, Jr, PHD PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

75-18P Issued in AR

Practice address

3104 S 70TH St
Suite #103
Fort Smith, AR 72903-5018

Phone

(479) 452-1658

Fax

(479) 452-3865

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1245314574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10105",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729170105",
            "telephone_number": "479-452-1658",
            "fax_number": "479-452-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 S 70TH ST",
            "address_2": "SUITE #103",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035018",
            "telephone_number": "479-452-1658",
            "fax_number": "479-452-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAY, JR",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PHD  PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "75-18P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56447",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105861719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.