Provider Demographics
NPI:1982957817
Name:LIFFERTH, SPENCER K (AUD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:K
Last Name:LIFFERTH
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5349 S ADAMS AVE PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405
Mailing Address - Country:US
Mailing Address - Phone:801-479-3346
Mailing Address - Fax:801-479-0725
Practice Address - Street 1:755 W ANTELOPE DR
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1630
Practice Address - Country:US
Practice Address - Phone:385-383-7162
Practice Address - Fax:385-383-7113
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2025-02-27
Deactivation Date:2019-01-22
Deactivation Code:
Reactivation Date:2019-02-25
Provider Licenses
StateLicense IDTaxonomies
UT97419074101237600000X, 231H00000X
WYA-1086237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter