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Individual

DR. KENNETH M SPILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4809 AMBASSADOR CAFFERY PKWY STE 305, LAFAYETTE, LA 70508-8800
(337) 470-3109
(337) 470-3110
Mailing address
4811 AMBASSADOR CAFFERY PKWY STE 305, LAFAYETTE, LA 70508-7266
(337) 470-3109
(337) 470-3110

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L018312
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1355984
LA
01
CK2924
RAILROAD MEDICARE
LA
Enumeration date
08/09/2006
Last updated
04/20/2021
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