Provider Demographics
NPI:1760772552
Name:SPENCE, ISAAC (DO)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:SPENCE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:901 PLANTATION RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-3880
Mailing Address - Country:US
Mailing Address - Phone:540-951-0352
Mailing Address - Fax:540-951-7724
Practice Address - Street 1:901 PLANTATION RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3880
Practice Address - Country:US
Practice Address - Phone:540-951-0352
Practice Address - Fax:540-951-7724
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102-203787207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVE193AOtherMEDICARE PTAN