Basic Information
| Provider Information | |||||||||
| NPI: | 1659001931 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPENSER REED MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1790 SUN PEAK DR STE A101 | ||||||||
| Address2: | |||||||||
| City: | PARK CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840986624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356450800 | ||||||||
| FaxNumber: | 4356473003 | ||||||||
| Practice Location | |||||||||
| Address1: | 1790 SUN PEAK DR STE A101 | ||||||||
| Address2: | |||||||||
| City: | PARK CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840986624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356450800 | ||||||||
| FaxNumber: | 4356473003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2022 | ||||||||
| LastUpdateDate: | 06/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | REED | ||||||||
| AuthorizedOfficialFirstName: | SPENSER | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4355136600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.