Individual
ROBERT DALE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
277 N HIGHWAY 171 STE 8, MOSS BLUFF, LA 70611-5374
(337) 312-0030
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
(337) 312-6711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200598
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2322885
—
LA
Enumeration date
12/04/2012
Last updated
04/12/2021
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