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General NPI Number Information
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NPI Number | 1164491999
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Entity Type | Individual
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Provider Name | SPENCER CONNERAT BLANTON MD
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 931 TOPPINO DR
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City | KEY WEST
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State | FL
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Zip | 33040-4269
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Country | US
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Telephone | 813-546-4532
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | SEDALIA
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State | MO
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Zip | 65302-1547
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Country | US
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Telephone | 660-826-5960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME67921
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License Number State | FL
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