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General NPI Number Information
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NPI Number | 1275514606
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Entity Type | Individual
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Provider Name | DR. SELDEN EDMUND SPENCER
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Gender | Male
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-8755
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Fax | 319-356-4505
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Provider Business Mailing Address
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Address Line | 823 ASHWOOD DR
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City | HUXLEY
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State | IA
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Zip | 50124-9316
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Country | US
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Telephone | 515-597-3165
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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 | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | MD-23942
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | MD-23942
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 23942
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License Number State | IA
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