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Individual

DR. SPENCER LEWIS MORTENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M

Contact information

Practice address
1500 DODSON AVE STE 260, FORT SMITH, AR 72901-5179
(479) 573-7905
(479) 573-7906
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 812-7215
(501) 812-7207

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5587758-0501
UT

Other

Enumeration date
11/09/2012
Last updated
12/18/2018
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