Healthcare Provider Details

I. General information

NPI: 1962995092
Provider Name (Legal Business Name): T RHETT SPENCER JR MD SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E CHEVES ST
FLORENCE SC
29506-2615
US

IV. Provider business mailing address

PO BOX 6225
FLORENCE SC
29502-6225
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-5904
  • Fax:
Mailing address:
  • Phone: 843-777-5904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. T RHETT SPENCER JR.
Title or Position: OWNER
Credential: MD
Phone: 843-777-5904