Provider Demographics
NPI:1194948901
Name:SPENCER, RUBEN (CSFA)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:SPENCER
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9915 STONEBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3561
Mailing Address - Country:US
Mailing Address - Phone:303-618-7748
Mailing Address - Fax:303-284-4989
Practice Address - Street 1:9915 STONEBRIAR LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3561
Practice Address - Country:US
Practice Address - Phone:303-618-7748
Practice Address - Fax:303-284-4989
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSA.0001022246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant