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Spencer C Tietjen

  • Male

Medical Specialty

Professional ID

  • NPI: 1851699003
  • PECOS ID: 8921271958
  • Enrollment ID: I20111107000790
  • Credential(MD, DO, DPM):
  • Medical School:
  • Medical School Graduation Year: 2011

Medical Practices

  • Organization Name: Gibbons Wood And Bennion, Pc.
  • Group Practice ID assigned by PECOS: 0547203945
  • Number of Group Practice member: 6

Location

  • Address1: 2380 N 400 E D
  • Address2:
  • City: North Logan
  • State: Utah
  • Zip Code: 84341
  • Phone Number: (435)753-7880

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):