Individual
ROY A SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
2701 N. DECATUR RD, DECATUR, GA 30033-0000
(678) 514-1991
(678) 514-1992
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
002181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000551B
—
GA
05
—
100001543A
—
GA
01
—
1679528475
NPI
GA
01
—
1982637419
GROUP NPI
GA
Enumeration date
05/23/2006
Last updated
04/10/2013
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