Provider Demographics
NPI:1518087162
Name:SPENGEL, KENNETH (DO)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:SPENGEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14425 COLLEGE BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2317
Mailing Address - Country:US
Mailing Address - Phone:913-396-8509
Mailing Address - Fax:913-495-9743
Practice Address - Street 1:14425 COLLEGE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2317
Practice Address - Country:US
Practice Address - Phone:913-396-8509
Practice Address - Fax:913-495-9743
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332697207ZP0102X
KS6080207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA332697OtherLA LICENSE
MO2007029609OtherLICENSE