Individual
MR. KENNETH LLOYD SPENCER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
815 PECAN GROVE RD E, SHERMAN, TX 75090-1768
(903) 892-2126
Mailing address
815 PECAN GROVE RD E, SHERMAN, TX 75090-1768
(903) 892-2126
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220047598
—
MO
Enumeration date
09/07/2017
Last updated
07/21/2022
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