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Individual

DR. MARK A SPENCER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1335 US HIGHWAY 68, MAYSVILLE, KY 41056-9132
(606) 564-4213
(606) 564-4406
Mailing address
103 DUNN CIR, GEORGETOWN, KY 40324-8796
(727) 644-4064
(502) 212-4334

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
250032
KY
111N00000X
Chiropractor
2916
OH
111N00000X
Chiropractor
9819
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000360683
ANTHEM PIN
KY
01
1179081
CHA PIN
KY
01
6079912
MEDICARE ID-TYPE UNSPECIFIED
KY
05
7100098410
KY
Enumeration date
08/30/2005
Last updated
07/19/2020
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