Provider Demographics
NPI:1134157340
Name:SPENCE, CAPLE A (MD)
Entity type:Individual
Prefix:DR
First Name:CAPLE
Middle Name:A
Last Name:SPENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 NATIONAL AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7570
Mailing Address - Country:US
Mailing Address - Phone:405-455-3393
Mailing Address - Fax:405-455-7162
Practice Address - Street 1:8121 NATIONAL AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7570
Practice Address - Country:US
Practice Address - Phone:405-455-3393
Practice Address - Fax:405-455-7162
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26541207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200222530AMedicaid
IA2418715Medicaid
IAH79837Medicare UPIN
IAI14732Medicare PIN