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Individual

SPENCER LUCILE CRAIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1265 UPPER HEMBREE RD STE 100, ROSWELL, GA 30076-1258
(770) 751-1133
(770) 751-7410
Mailing address
1265 UPPER HEMBREE RD STE 100, ROSWELL, GA 30076-1258
(770) 751-1133
(770) 751-7410

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9164
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9164
PHYSICIAN ASSISTANT LICENSE
GA
Enumeration date
03/08/2019
Last updated
03/08/2019
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