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NPI Code Detail

MEDICARE: JAMIE SPENCER PA

MEDICARE: JAMIE SPENCER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.007300RXOH
2363A00000XPhysician Assistant5601010320MI

General Provider Information

NPI Number : 1023609419
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE SPENCER PA
Provider Business Mailing Address
First Line : 3000 ARLINGTON AVE STOP 1108
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14671 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-3300
Country : US
Telephone Number : 313-948-3055
Fax Number : 313-948-3041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2021
Last Update Date : 01/22/2026

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Directions to “ JAMIE SPENCER PA” Practice Location

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