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General NPI Number Information
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NPI Number | 1083619076
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Entity Type | Individual
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Provider Name | LEO JOSEPH SPITTLER MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 3500 S 4TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5043
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Country | US
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Telephone | 913-680-6297
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Fax | 913-680-6408
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Provider Business Mailing Address
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Address Line | 5800 FOXRIDGE DR STE 240
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City | MISSION
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State | KS
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Zip | 66202-2338
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Country | US
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Telephone | 913-261-3153
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Fax | 913-262-3295
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-20507
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R9121
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License Number State | MO
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