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DR. SPENCER ANDERSEN D.O.

>> Surgery >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1295130961

Individual Registrant:
DR. SPENCER  ANDERSEN D.O.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
501 N NAVAJO DR  PAGE, AZ 86040 US
Tel: 801-885-2489  Fax: --

Contact information for business:
501 N NAVAJO DR  PAGE, AZ 86040-0959 US
Tel: 801-885-2489  Fax: --

Registration Information:
NPI: 1295130961
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208600000XAllopathic & Osteopathic Physicians
Surgery
NY286582
N390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE LICENCE286582NY01




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