MEDICARE: KEVIN SCOTT SPIRES MD

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	208800000X	Urology Physician	ME 84672	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750338885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN SCOTT SPIRES MD

Provider Business Mailing Address
First Line	:	7614 JACQUE RD
Second Line	:	SUITE A
City	:	HUDSON
State	:	FL
Zip	:	34667-7195
Country	:	US
Telephone Number	:	727-862-8548
Fax Number	:	727-863-4530

Provider Business Practice Location Address
First Line	:	7614 JACQUE RD
Second Line	:	SUITE A
City	:	HUDSON
State	:	FL
Zip	:	34667-7195
Country	:	US
Telephone Number	:	727-862-8548
Fax Number	:	727-863-4530

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/08/2007

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