Individual
DR. MATTHEW S SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2075 UNIVERSITY PARK BLVD, LAYTON, UT 84041-1611
(801) 779-6200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 779-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7078640-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245496397
—
UT
01
—
P00876422
MEDICARE RAILROAD
UT
Enumeration date
07/29/2008
Last updated
05/11/2011
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