MEDICARE: KYLLINGTON LEIGH SPOTTS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-15763	NC
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1457950867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLLINGTON LEIGH SPOTTS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 936857
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-6857
Country	:	US
Telephone Number	:	910-662-8765
Fax Number	:	910-362-9123

Provider Business Practice Location Address
First Line	:	3400 CIVIC CENTER BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5127
Country	:	US
Telephone Number	:	215-662-2891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2020
Last Update Date	:	12/03/2025

Similar Medicare Providers

1174486989 — JHEESOO AHN
Practice Location Address:

3400 CIVIC CENTER BLVD
PHILADELPHIA, PA
19104-5127

Practice Phone: 215-662-2000
Practice Fax:

1023978251 — MR. OMKAR S. ANASPURE
Practice Location Address:

3400 CIVIC CENTER BLVD
PHILADELPHIA, PA
19104-5127

Practice Phone: 215-662-4000
Practice Fax:

1548203342 — DOUGLAS B CINES MD
Practice Location Address:

3400 CIVIC CENTER BLVD , 2ND FLOOR
PHILADELPHIA, PA
19104-5127

Practice Phone: 215-615-5858
Practice Fax:

1093565442 — NICHOLAS RYAN JOHNSTON
Practice Location Address:

3400 CIVIC CENTER BLVD
PHILADELPHIA, PA
19104-5127

Practice Phone: 925-640-4205
Practice Fax:

1649790247 — DR. SIERRA ROSE VAN DEN DRIES DMD
Practice Location Address:

3400 CIVIC CENTER BLVD
PHILADELPHIA, PA
19104-5127

Practice Phone: 215-662-8221
Practice Fax:

1861706525 — MICHAEL A GELFAND MD
Practice Location Address:

3400 CIVIC CENTER BLVD , 2ND FLOOR, SOUTH PAVILION
PHILADELPHIA, PA
19104-5127

Practice Phone: 215-662-3606
Practice Fax: 215-243-2312

Directions to “ KYLLINGTON LEIGH SPOTTS PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.