Basic Information
| Provider Information | |||||||||
| NPI: | 1003138835 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPIEGEL | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD., RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14209 MACKEY ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662232568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138517007 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7836 STATE AVE | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661122417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132996016 | ||||||||
| FaxNumber: | 9132991735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2010 | ||||||||
| LastUpdateDate: | 02/21/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 1-13199 | KS | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.