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Individual

JUDY MARIE SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-8545
(304) 872-0675
Mailing address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-8545
(304) 872-0675

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
778
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001771978
MS BCBS
WV
05
3810000489
WV
Enumeration date
12/14/2005
Last updated
08/28/2013
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