Individual
CLAY R SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W MAIN ST, WALNUT RIDGE, AR 72476-1005
(870) 886-3543
(870) 886-3252
Mailing address
PO BOX 719, WALNUT RIDGE, AR 72476-0719
(870) 886-3543
(870) 886-3252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3566
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150630001
—
AR
01
—
5M488
BLUE CROSS BLUE SHIELD
AR
Enumeration date
10/20/2006
Last updated
01/22/2010
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