Individual
SPENSER INTERLICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 BRANSON LANDING BLVD, BRANSON, MO 65616-2052
(417) 335-7000
Mailing address
52 MILES STANDISH RD, ROTTERDAM, NY 12306-3323
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2026007540
MO
208M00000X
Hospitalist Physician
Primary
TBD
MO
Other
Enumeration date
02/12/2026
Last updated
04/22/2026
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