Provider Demographics
NPI:1144356890
Name:SPANGLER, JILL KRISTINE (DO)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:KRISTINE
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:900 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3210
Mailing Address - Country:US
Mailing Address - Phone:417-667-6015
Mailing Address - Fax:417-667-3007
Practice Address - Street 1:900 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3210
Practice Address - Country:US
Practice Address - Phone:417-667-6015
Practice Address - Fax:471-667-3007
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2005019623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI39416Medicare UPIN