Provider Demographics
NPI:1780062273
Name:SPENCER MUNICIPAL HOSPITAL
Entity type:Organization
Organization Name:SPENCER MUNICIPAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIEFENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-264-6111
Mailing Address - Street 1:101 E 10TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4307
Mailing Address - Country:US
Mailing Address - Phone:712-264-3500
Mailing Address - Fax:
Practice Address - Street 1:101 E 10TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4307
Practice Address - Country:US
Practice Address - Phone:712-264-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty