Provider Demographics
NPI:1780263210
Name:SPENCER, JORDAN ELISE (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ELISE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:406 ALEX JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:DUENWEG
Mailing Address - State:MO
Mailing Address - Zip Code:64841-1091
Mailing Address - Country:US
Mailing Address - Phone:479-719-9425
Mailing Address - Fax:
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:479-719-9425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025030193207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology