Healthcare Provider Details

I. General information

NPI: 1740279504
Provider Name (Legal Business Name): ELIZABETH BROOKE SPENCER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: E. BROOKE SPENCER M.D.

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8671 S QUEBEC ST STE 200
HIGHLANDS RANCH CO
80130
US

IV. Provider business mailing address

8671 S QUEBEC ST STE 200
HIGHLANDS RANCH CO
80130-5861
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-7477
  • Fax: 303-805-7478
Mailing address:
  • Phone: 303-805-7477
  • Fax: 303-805-7478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number48034
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberCDRH.0048034
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: