Provider Demographics
NPI:1326445958
Name:SPENCER, CHASE ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:CHASE
Middle Name:ALEXANDER
Last Name:SPENCER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W LINN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5837
Mailing Address - Country:US
Mailing Address - Phone:405-321-0022
Mailing Address - Fax:405-360-4918
Practice Address - Street 1:215 W LINN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5837
Practice Address - Country:US
Practice Address - Phone:405-321-0022
Practice Address - Fax:405-360-4918
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist