Provider Demographics
NPI:1467484857
Name:SCHUENMAN, SPENCER F (DO)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:F
Last Name:SCHUENMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1427
Mailing Address - Country:US
Mailing Address - Phone:928-777-9950
Mailing Address - Fax:928-777-9975
Practice Address - Street 1:3336 S PIONEER PKWY STE 102
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2072
Practice Address - Country:US
Practice Address - Phone:801-964-3925
Practice Address - Fax:801-964-3928
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10502228-1204207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3004638Medicaid
AZZ142534OtherMEDICARE PTAN