Provider Demographics
NPI:1821667544
Name:SPAIN-MANSMANN, KATIE K (DO)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:K
Last Name:SPAIN-MANSMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3368 HWY 280, SUITE 218
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010
Mailing Address - Country:US
Mailing Address - Phone:256-215-7460
Mailing Address - Fax:256-215-7457
Practice Address - Street 1:3368 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3369
Practice Address - Country:US
Practice Address - Phone:256-215-7460
Practice Address - Fax:256-215-7457
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL3210207R00000X
ALDO.3210207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine