Basic Information
| Provider Information | |||||||||
| NPI: | 1972644821 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNEY | ||||||||
| FirstName: | SPENCER | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3970 SOUTH 700 EAST | ||||||||
| Address2: | SUITE 14 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012613605 | ||||||||
| FaxNumber: | 8012629142 | ||||||||
| Practice Location | |||||||||
| Address1: | 3970 SOUTH 700 EAST | ||||||||
| Address2: | SUITE 14 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012613605 | ||||||||
| FaxNumber: | 8012629142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 74303492-1205 | UT | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 2005-0325 | NM | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1972644821 | 05 | UT | MEDICAID |