Organization
PREMIER DERMATOLOGIC SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH A SPENCERI M.D. (MEDICAL DIRECTOR)
(913) 327-1117
Entity
Organization
Contact information
Practice address
12200 W 106TH ST, SUITE 210, OVERLAND PARK, KS 66215-2300
(913) 327-1117
(913) 327-1119
Mailing address
12200 W 106TH ST, SUITE 210, OVERLAND PARK, KS 66215-2300
(913) 327-1117
(913) 327-1119
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30619
KS
Other
Enumeration date
07/16/2006
Last updated
05/09/2008
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