Spencer, Donavan D

Spencer, Donavan D is an individual health care provider with primary practice located at 205 South St , Fort Bragg CA 95437-5540. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Spencer, Donavan D can be contacted via phone (707) 964-1251.

Contact Information

Primary practice address
205 South St Fort Bragg CA 95437-5540
Phone: (707) 964-1251
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD26431 Maine
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G85455 California

Profile Details

NPI number 1609803691
LBN Legal business name Spencer, Donavan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Nov 11th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609803691 NPPES
California Other 00G854550 BS OF CA
California MEDICAID 00G854550 BS OF CA

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