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Individual

ARIEL SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
207 N TOWNLINE RD STE 101, LAGRANGE, IN 46761-1325
(260) 463-9316
(260) 463-9334
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01066930A
IN
208600000X
Surgery Physician
MD 47599
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD 47599
TN MEDICAL LICENSE
TN
Enumeration date
05/16/2007
Last updated
10/12/2022
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