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General NPI Number Information
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NPI Number | 1225007446
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Entity Type | Individual
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Provider Name | ROBERTO R SPENCER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 12687 W CEDAR DR 200
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City | LAKEWOOD
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State | CO
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Zip | 80228-2010
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Country | US
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Telephone | 303-468-1395
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Fax | 303-468-1394
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Provider Business Mailing Address
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Address Line | 1052 SLEEPY HOLLOW RD
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City | GOLDEN
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State | CO
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Zip | 80401-8037
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Country | US
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Telephone | 303-468-1395
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Fax | 303-468-1394
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 38428
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 82-314
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License Number State | NM
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