Provider Demographics
NPI:1386842755
Name:SPENCER, DAVID LAMAR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LAMAR
Last Name:SPENCER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2525 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39567-3202
Mailing Address - Country:US
Mailing Address - Phone:228-762-4483
Mailing Address - Fax:228-769-0406
Practice Address - Street 1:2525 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-3202
Practice Address - Country:US
Practice Address - Phone:228-762-4483
Practice Address - Fax:228-769-0406
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MST-1860208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology