Provider Demographics
NPI:1700400157
Name:TRAXLER, SPENCER E (OD)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:E
Last Name:TRAXLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LOW ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4114
Mailing Address - Country:US
Mailing Address - Phone:978-462-2020
Mailing Address - Fax:978-462-4263
Practice Address - Street 1:33 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-4114
Practice Address - Country:US
Practice Address - Phone:978-462-2020
Practice Address - Fax:978-462-4263
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00000152W00000X
IA117721152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist