Provider Demographics
NPI:1093465692
Name:HEGERHORST, SPENCER BRUCE (DO)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:BRUCE
Last Name:HEGERHORST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WICKS LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3810
Mailing Address - Country:US
Mailing Address - Phone:406-237-8300
Mailing Address - Fax:
Practice Address - Street 1:32 WICKS LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3810
Practice Address - Country:US
Practice Address - Phone:406-237-8300
Practice Address - Fax:406-237-8333
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT160295207Q00000X
COTL.0009167390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine