Provider Demographics
NPI:1588668867
Name:SPICER, DONALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:SPICER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-415-7653
Mailing Address - Fax:270-575-8359
Practice Address - Street 1:2603 KENTUCKY AVE
Practice Address - Street 2:STE 102
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3815
Practice Address - Country:US
Practice Address - Phone:270-442-3539
Practice Address - Fax:270-442-2051
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2020-12-03
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Provider Licenses
StateLicense IDTaxonomies
KY32040208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64320401Medicaid
KY64320401Medicaid
KYF65377Medicare UPIN