MEDICARE: JAMES CONRAD SPILS 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
1	207L00000X	Anesthesiology Physician	3440	AK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	050084272	OTHER	AK	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0149083	OTHER	WA	WA DEPT. OF LABOR
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	995202149	OTHER	WA	OFFICE OF WORKER'S COMP

General Provider Information

NPI Number	:	1497744965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CONRAD SPILS M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 241689
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-1889
Country	:	US
Telephone Number	:	907-563-1777
Fax Number	:	907-561-7464

Provider Business Practice Location Address
First Line	:	4001 LAUREL ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5300
Country	:	US
Telephone Number	:	907-563-1800
Fax Number	:	907-563-1802

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	02/22/2011

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Directions to “ JAMES CONRAD SPILS M.D.” Practice Location

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