Individual
THOMAS S SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 E CULVER RD, SUITE 103, KNOX, IN 46534-2216
(574) 772-2114
(574) 772-2802
Mailing address
2335 W BROOKS BLUFF, NORTH JUDSON, IN 46366
(574) 933-1420
(574) 772-2802
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
22329
OK
207V00000X
Obstetrics & Gynecology Physician
Primary
01053871A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000518052
ANTHEM BLUE CROSS
IN
05
—
200860120
—
IN
Enumeration date
03/31/2006
Last updated
07/07/2008
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