Provider Demographics
NPI:1376725416
Name:SPIESS, MICHAEL ANTHONY (D,C,)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:SPIESS
Suffix:
Gender:M
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15203 W 87TH STREET PKWY
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1409
Mailing Address - Country:US
Mailing Address - Phone:913-648-7246
Mailing Address - Fax:913-599-1548
Practice Address - Street 1:15203 W 87TH STREET PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1409
Practice Address - Country:US
Practice Address - Phone:913-648-7246
Practice Address - Fax:913-599-1548
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
7746743OtherAETNA
KS203314OtherBC/BS OF KANSAS
34943017OtherBC/BS
34971012OtherBC/BS
KSS08000OtherMEDICARE PTAN
7746743OtherAETNA