Healthcare Provider Details

I. General information

NPI: 1477602795
Provider Name (Legal Business Name): ROBERT F SPENCER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 PEMBROKE RD STE. 250
CONCORD NH
03301-5792
US

IV. Provider business mailing address

PO BOX 2552
CONCORD NH
03302-2552
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-7160
  • Fax: 603-228-7168
Mailing address:
  • Phone: 603-228-7160
  • Fax: 603-228-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number9752
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number9752
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: