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Individual
SPENCER EVAN BLACK
Active
Individual
SPENCER EVAN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
12759564-1205
UT
2084P0800X
Psychiatry Physician
12759564-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
12759564-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
12759564-8905
UT
Other
Enumeration date
03/22/2017
Last updated
09/16/2026
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