Provider Demographics
NPI:1144072836
Name:CARDEN, SPENCER O'BRIEN (PA-C)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:O'BRIEN
Last Name:CARDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SPENCER
Other - Middle Name:O'BRIEN
Other - Last Name:GRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 MCFARLAND RD APT 3
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30750-3127
Mailing Address - Country:US
Mailing Address - Phone:812-208-5462
Mailing Address - Fax:
Practice Address - Street 1:45 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-0600
Practice Address - Country:US
Practice Address - Phone:706-965-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant