Provider Demographics
NPI:1558466144
Name:SPILLERS, STEVEN HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HOWARD
Last Name:SPILLERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 N WEBER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7532
Mailing Address - Country:US
Mailing Address - Phone:719-955-6481
Mailing Address - Fax:719-227-9013
Practice Address - Street 1:1715 N WEBER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7532
Practice Address - Country:US
Practice Address - Phone:719-955-6481
Practice Address - Fax:719-227-9013
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO414922084N0400X
KY438282084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98788531Medicaid
COC536678Medicare ID - Type Unspecified
COF40650Medicare UPIN