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Individual

JARED R SPENCER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6823 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 750-2080
(479) 750-2082
Mailing address
6823 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 750-2080
(479) 750-2082

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
37260
AZ
207YS0123X
Facial Plastic Surgery Physician
A95600
CA
207YS0123X
Facial Plastic Surgery Physician
Primary
E6045
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
179309001
AR
Enumeration date
06/18/2007
Last updated
03/12/2013
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