Organization
DRS CLACK SPENCER WHITE & MCCORMACK PA
Active
Other names
Sarasota Pathology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J ROBERT SPENCER M.D. (TREASURER)
(941) 362-8900
Entity
Organization
Contact information
Practice address
2001 WEBBER ST, SARASOTA, FL 34239-5237
(941) 362-8900
(941) 362-8933
Mailing address
2001 WEBBER ST, SARASOTA, FL 34239-5237
(941) 362-8900
(941) 362-8987
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
800000813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058166600
—
FL
01
—
209040
STAYWELL
FL
01
—
690005346
PALMETTO GBA
FL
01
—
99676
BLUE SHIELD
FL
01
—
L8218
BCBS LAB
FL
Enumeration date
04/03/2006
Last updated
05/16/2012
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