Provider Demographics
NPI:1073993556
Name:SPENCER, PHILLIP MATTHEW (PA)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:MATTHEW
Last Name:SPENCER
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Gender:
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:10401 W. THUNDERBIRD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351
Mailing Address - Country:US
Mailing Address - Phone:623-977-7211
Mailing Address - Fax:480-256-3682
Practice Address - Street 1:10401 W. THUNDERBIRD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-977-7211
Practice Address - Fax:480-256-3682
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ6048363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant