Individual
JUSTIN R SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6030 S MASON MONTGOMERY RD, MASON, OH 45040-3706
(513) 246-7000
(513) 204-6352
Mailing address
8094 BEECHMONT AVE, CINCINNATI, OH 45255-3145
(513) 232-7100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35133063
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2565399
—
OH
Enumeration date
12/03/2015
Last updated
12/15/2020
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