Individual
JACK CHRISTOPHER SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
181 CALHOUN ST, CHARLESTON, SC 29424
(843) 953-5520
Mailing address
181 CALHOUN ST, CHARLESTON, SC 29424-0001
(843) 953-5520
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22163
SC
207Q00000X
Family Medicine Physician
MD22163
SC
208D00000X
General Practice Physician
Primary
22163
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221637
—
SC
Enumeration date
05/01/2006
Last updated
10/02/2018
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