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General NPI Number Information
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NPI Number | 1609512193
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Entity Type | Individual
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Provider Name | SPENCER HART
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Gender | Male
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 201 COLONIAL DR
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City | WALNUT RIDGE
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State | AR
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Zip | 72476-1410
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Country | US
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Telephone | 870-886-5507
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Fax | 870-886-5632
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Provider Business Mailing Address
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Address Line | PO BOX 83
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City | CORNING
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State | AR
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Zip | 72422-0083
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Country | US
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Telephone | 870-857-3334
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Fax | 870-857-9934
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-17357
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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