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NPI Code Detail

MEDICARE: SPENCER ALEXANDER DPM

MEDICARE: SPENCER ALEXANDER DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist305AR

General Provider Information

NPI Number : 1659877884
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER ALEXANDER DPM
Provider Business Mailing Address
First Line : 200 S 20TH ST STE B
Second Line :
City : ROGERS
State : AR
Zip : 72758-1100
Country : US
Telephone Number : 479-636-9393
Fax Number : 479-636-9341
Provider Business Practice Location Address
First Line : 200 S 20TH ST STE B
Second Line :
City : ROGERS
State : AR
Zip : 72758-1100
Country : US
Telephone Number : 479-636-9393
Fax Number : 479-636-9341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2018
Last Update Date : 10/27/2023

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Directions to “ SPENCER ALEXANDER DPM” Practice Location

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