Individual
DR. SIDNEY W SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
118 GOLF COURSE RD, PILOT MTN, NC 27041
(336) 368-4727
(336) 368-5627
Mailing address
PO BOX 607, PILOT MTN, NC 27041
(336) 368-4727
(336) 368-5627
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
#0951
NC
152W00000X
Optometrist
0951
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79-09862
—
NC
05
—
7909862
—
NC
Enumeration date
10/20/2005
Last updated
03/26/2009
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