# SPENCER MUNICIPAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Spencer, a Department of Spencer Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780062273
- **Authorized official:** BRENDA TIEFENTHALER (CEO)
- **Authorized official phone:** (712) 264-6111

## Contact information

- **Practice address:** 101 E 10TH ST, SUITE 101, SPENCER, IA 51301-4307
- **Practice address phone:** (712) 264-3500
- **Mailing address:** 101 E 10TH ST, SUITE 101, SPENCER, IA 51301-4307
- **Mailing address phone:** (712) 264-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 05/15/2015
- **Last updated:** 07/05/2024