Provider Demographics
NPI:1659001931
Name:SPENSER REED MD PLLC
Entity Type:Organization
Organization Name:SPENSER REED MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPENSER
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-513-6600
Mailing Address - Street 1:1790 SUN PEAK DR STE A101
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-6624
Mailing Address - Country:US
Mailing Address - Phone:435-645-0800
Mailing Address - Fax:435-647-3003
Practice Address - Street 1:1790 SUN PEAK DR STE A101
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6624
Practice Address - Country:US
Practice Address - Phone:435-645-0800
Practice Address - Fax:435-647-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty