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NPI Code Detail

MEDICARE: DR. KIMBERLY A SPENCER MD

MEDICARE: DR. KIMBERLY A SPENCER MD
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
12085R0202XDiagnostic Radiology Physician33714GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326020785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY A SPENCER MD
Provider Business Mailing Address
First Line : PO BOX 3157
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-3157
Country : US
Telephone Number : 770-405-2976
Fax Number :
Provider Business Practice Location Address
First Line : 790 CHURCH ST NE STE 400
Second Line :
City : MARIETTA
State : GA
Zip : 30060-8957
Country : US
Telephone Number : 770-405-2976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 02/28/2024

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Directions to “ DR. KIMBERLY A SPENCER MD” Practice Location

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