Provider Demographics
NPI:1427582840
Name:SPENCER, NATHANIEL ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:ANDREW
Last Name:SPENCER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:126 US HIGHWAY 280 W
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31719-8645
Mailing Address - Country:US
Mailing Address - Phone:229-931-1123
Mailing Address - Fax:229-931-1124
Practice Address - Street 1:9228 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9125
Practice Address - Country:US
Practice Address - Phone:843-876-7080
Practice Address - Fax:843-876-7111
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA970492085R0202X
SC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology