Provider Demographics
NPI:1659877884
Name:ALEXANDER, SPENCER (DPM)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S 20TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1100
Mailing Address - Country:US
Mailing Address - Phone:479-636-9393
Mailing Address - Fax:479-636-9341
Practice Address - Street 1:200 S 20TH ST STE B
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1100
Practice Address - Country:US
Practice Address - Phone:479-636-9393
Practice Address - Fax:479-636-9341
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR305213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery