MEDICARE: DR. ROBERT L SPENCE M.D.

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
1	207P00000X	Emergency Medicine Physician	2006010650	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1588653125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L SPENCE M.D.

Provider Business Mailing Address
First Line	:	304 S JONES BLVD # 5438
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	27-468-2981
Fax Number	:	27-935-9135

Provider Business Practice Location Address
First Line	:	6900 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4409
Country	:	US
Telephone Number	:	702-835-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	12/21/2021

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Directions to “ DR. ROBERT L SPENCE M.D.” Practice Location

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