Spencer Corey Southerland, IDC

NPI #1922359702 in Jbphh, Hawaii

Provider Information

NPI Number: 1922359702
Entity Type: Individual
Name: Spencer Corey Southerland, IDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Military Health Care Provider
Credential: IDC
Enumeration Date: Sep 20, 2012
Last Updated: Apr 3, 2025

Practice Location

Address: 480 CENTRAL AVE
City: Jbphh
State: Hawaii
ZIP Code: 96860-4908
Phone: (808) 869-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider	171000000X	Primary

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