Provider Demographics
NPI:1942660030
Name:SMITH, SPENCER CHAD (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:CHAD
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-2728
Mailing Address - Country:US
Mailing Address - Phone:870-831-5016
Mailing Address - Fax:
Practice Address - Street 1:406 E SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646-2728
Practice Address - Country:US
Practice Address - Phone:870-831-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor