{
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"OrgName": "SPENCER J HARDENBROOK MD PC",
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"FirstLineMailingAddress": "PO BOX 1200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLEASANT GROVE",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84062-1200",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-640-3451",
"MailingAddressFaxNumber": "385-287-1900",
"FirstLinePracticeLocationAddress": "12176 S 1000 E STE 4",
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"PracticeLocationAddressCityName": "DRAPER",
"PracticeLocationAddressStateName": "UT",
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"PracticeLocationAddressTelephoneNumber": "800-640-3451",
"PracticeLocationAddressFaxNumber": "385-287-1900",
"EnumerationDate": "04/10/2015",
"LastUpdateDate": "11/06/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDERSON HANKINS",
"AuthorizedOfficialFirstName": "MARIANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "801-888-1140",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "88335211205",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}