Individual
SHANNA LEIGH SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 E 6TH ST, TEXARKANA, AR 71854-5207
(870) 779-6004
(870) 779-6100
Mailing address
300 E 6TH ST, TEXARKANA, AR 71854-5207
(870) 779-6004
(870) 779-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C8442
AR
207Q00000X
Family Medicine Physician
K1075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B4912
TRALBLAZERS
—
Enumeration date
07/07/2005
Last updated
08/22/2007
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