Grant-Spencer, Telitha K

Grant-Spencer, Telitha K is an sole proprietor health care provider with primary practice located at 1488 Hwy 487 , Sebastopol MS 39359-0150. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Grant-Spencer, Telitha K can be contacted via phone (601) 625-7403.

Contact Information

Primary practice address
1488 Hwy 487 Sebastopol MS 39359-0150
Phone: (601) 625-7403
Fax: (601) 625-7404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD.200333 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 24502 Mississippi
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD.200333 Louisiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 24502 Mississippi

Profile Details

NPI number 1851570006
LBN Legal business name Grant-Spencer, Telitha K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2007
Last updated Nov 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851570006 NPPES
Mississippi MEDICAID 00656244
Mississippi MEDICAID 1069973

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