Individual
DR. DAVID KEITH SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
711 N MAIN ST, BENTON, IL 62812-1017
(618) 439-7256
(618) 439-7257
Mailing address
711 N MAIN ST, BENTON, IL 62812-1017
(618) 439-7256
(618) 439-7257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007635
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007635
—
IL
Enumeration date
08/02/2006
Last updated
04/25/2008
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