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Individual

DR. JOHN V SPENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 HARRIS INDUSTRIAL BLVD, SUITE E, VIDALIA, GA 30474-8852
(770) 309-6636
(912) 277-2080
Mailing address
101 HARRIS INDUSTRIAL BLVD, SUITE E, VIDALIA, GA 30474-8852
(912) 277-2077
(912) 277-2080

Taxonomy

Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
55572
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
880364664A
GA
Enumeration date
07/31/2006
Last updated
08/17/2011
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