Provider Demographics
NPI:1578942611
Name:SPELLINGS, KRISTIE ANN (DO)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:ANN
Last Name:SPELLINGS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:KRISTIE
Other - Middle Name:ANN
Other - Last Name:BRONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2002 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-4163
Mailing Address - Country:US
Mailing Address - Phone:251-937-5377
Mailing Address - Fax:251-937-5352
Practice Address - Street 1:2002 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4163
Practice Address - Country:US
Practice Address - Phone:251-937-5377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0005636207Q00000X
ORDO186649207Q00000X
ALDO.3115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500746263Medicaid