Provider Demographics
NPI:1073507893
Name:CHECKETTS, SPENCER CRAIG (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:CRAIG
Last Name:CHECKETTS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E FOREST ST # 1
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-3603
Mailing Address - Country:US
Mailing Address - Phone:435-553-4787
Mailing Address - Fax:435-239-7089
Practice Address - Street 1:111 E FOREST ST # 1
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3603
Practice Address - Country:US
Practice Address - Phone:435-553-4787
Practice Address - Fax:435-239-7089
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT359818-12052083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine