Provider Demographics
NPI:1710972708
Name:SPIREK, ANITA J (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:SPIREK
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1140 LEXINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9330
Mailing Address - Country:US
Mailing Address - Phone:502-867-2155
Mailing Address - Fax:502-867-2122
Practice Address - Street 1:1140 LEXINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9330
Practice Address - Country:US
Practice Address - Phone:502-867-2155
Practice Address - Fax:502-867-2122
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31354207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64313547Medicaid
KY0912101OtherMEDICARE PTAN
KYG76470Medicare UPIN