1841294287 NPI number — DR. EUGENE C SPILKER DC

Table of content: DR. EUGENE C SPILKER DC (NPI 1841294287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841294287 NPI number — DR. EUGENE C SPILKER DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPILKER
Provider First Name:
EUGENE
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841294287
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1381 HIGH ST
Provider Second Line Business Mailing Address:
STE 211
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63090-6446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-390-9990
Provider Business Mailing Address Fax Number:
636-390-9994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1381 HIGH ST
Provider Second Line Business Practice Location Address:
STE 211
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63090-6446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-390-9990
Provider Business Practice Location Address Fax Number:
636-390-9994
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2000153532 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 443880 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 130095 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 186469 . This is a "GHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: U81393 . This is a "MERCY HEALTH PLANS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 186469 . This is a "CMR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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