Individual
CHARLES S SPILLMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
800 ROSE ST RM C224, LEXINGTON, KY 40536-0293
(858) 323-6346
Mailing address
800 ROSE ST RM C224, LEXINGTON, KY 40536-0001
(859) 323-6346
(859) 323-6840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
885
KY
363AS0400X
Surgical Physician Assistant
Primary
KY 885
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
02/22/2007
Last updated
02/04/2021
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