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NPI Code Detail

MEDICARE: DR. PAUL CRAIG SPILLER M.D.

MEDICARE: DR. PAUL CRAIG SPILLER M.D.
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
1207Q00000XFamily Medicine Physician040557GA
2207Q00000XFamily Medicine Physician22040SC
3207Q00000XFamily Medicine PhysicianQ7483TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4202660098OTHERSCGAFFNEY HMA PHYSICIAN MANAGEMENT

General Provider Information

NPI Number : 1154320935
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL CRAIG SPILLER M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-8800
Fax Number :
Provider Business Practice Location Address
First Line : 1507 RIVERY BLVD
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3058
Country : US
Telephone Number : 512-509-9550
Fax Number : 512-509-9555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 02/21/2017

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