Individual
CORY SPICER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R74548
AZ
2085R0202X
Diagnostic Radiology Physician
12620A
WY
2085R0202X
Diagnostic Radiology Physician
Primary
M-15070
ID
2085R0202X
Diagnostic Radiology Physician
MED-PHYS-LIC-80820
MT
2085R0202X
Diagnostic Radiology Physician
R74548
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932512811
—
ID
Enumeration date
06/09/2014
Last updated
05/06/2020
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