| Spencer Family Medicine, Pc | |
|
650 Henderson Dr Ste 504 Cartersville GA 30120-3760 | |
| (770) 607-9032 | |
| (770) 607-9035 |
| Full Name | Spencer Family Medicine, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 650 Henderson Dr Ste 504, Cartersville, Georgia |
| Authorized Official Name and Position | Louis Andre Spencer (MEDICAL DOCTOR) |
| Authorized Official Contact | 7706079032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spencer Family Medicine, Pc 650 Henderson Drive, Suite 504 Cartersville GA 30120-3744 Ph: (770) 607-9032 | Spencer Family Medicine, Pc 650 Henderson Dr Ste 504 Cartersville GA 30120-3760 Ph: (770) 607-9032 |
| NPI Number | 1558748244 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8022310630 |
|---|---|
| Medicare Enrollment ID | O20160113000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558748244 | NPI | - | NPPES |
| 1558748244 | Other | GA | EIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Louis Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669642484 PECOS PAC ID: 0345316758 Enrollment ID: I20080909000653 |
| Provider Name | Heather Denise Czarnecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780140269 PECOS PAC ID: 2466794185 Enrollment ID: I20190430000715 |
| Provider Name | Kellie Bevans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134749955 PECOS PAC ID: 8224429865 Enrollment ID: I20211215002317 |
| Provider Name | Daniella Salazar Stearns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578103123 PECOS PAC ID: 1759736366 Enrollment ID: I20240422000841 |
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