Healthcare Provider Details

I. General information

NPI: 1124273784
Provider Name (Legal Business Name): CAPLE A. SPENCE M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 NATIONAL AVE STE. 210
OKLAHOMA CITY OK
73110-7530
US

IV. Provider business mailing address

8121 NATIONAL AVE SUITE 210
MIDWEST CITY OK
73110-7530
US

V. Phone/Fax

Practice location:
  • Phone: 405-455-3393
  • Fax: 405-455-7192
Mailing address:
  • Phone: 405-455-3393
  • Fax: 405-455-7192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number26541
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateOK

VIII. Authorized Official

Name: DR. CAPLE A SPENCE
Title or Position: OWNER
Credential: M.D.
Phone: 405-628-6808