Provider Demographics
NPI:1174573968
Name:SPANGLER, WENDELL JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:JAMES
Last Name:SPANGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 W WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:PAULDING
Mailing Address - State:OH
Mailing Address - Zip Code:45879-1545
Mailing Address - Country:US
Mailing Address - Phone:419-399-2045
Mailing Address - Fax:
Practice Address - Street 1:1032 W WAYNE ST
Practice Address - Street 2:
Practice Address - City:PAULDING
Practice Address - State:OH
Practice Address - Zip Code:45879-1545
Practice Address - Country:US
Practice Address - Phone:419-399-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-079361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2317719Medicaid
OH2317719Medicaid
OHSP4073222Medicare ID - Type Unspecified