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General NPI Number Information
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NPI Number | 1922051168
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Entity Type | Organization
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Legal Business Name | PATRICK L SPENCER DO, INC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 425 W GRAND AVE STE 1002
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7870
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Fax | 937-226-7829
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Provider Business Mailing Address
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Address Line | 425 W GRAND AVE STE 1002
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7870
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Fax | 937-226-7829
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK L SPENCER
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Credential | D.O.
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Telephone | 937-226-7870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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