Healthcare Provider Details

I. General information

NPI: 1538336441
Provider Name (Legal Business Name): DR SPENCE D HARPER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 NORTH MAIN STREET
HEBER CITY UT
84032
US

IV. Provider business mailing address

190 NORTH MAIN STREET
HEBER CITY UT
84032
US

V. Phone/Fax

Practice location:
  • Phone: 435-657-0329
  • Fax: 801-274-9064
Mailing address:
  • Phone: 435-657-0329
  • Fax: 801-274-9064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number314751-0501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1131960001
License Number StateUT

VIII. Authorized Official

Name: SPENCE D. HARPER
Title or Position: PHYSICIAN / OWNER
Credential: DPM
Phone: 801-274-9062