Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mitchell Wade Spencer, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1649912387

Mitchell Wade Spencer, DO is a Family Practice in Phoenix, Arizona. Qualified in 2022, 4 years ago. Practices with Banner Primary Care Physicians Arizona LLC, a 237-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4530 E Ray Rd Ste 190
Phoenix, AZ 85044-6098
Phone: (808) 275-4204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 011824 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1649912387
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 12, 2022
Last updated in NPPESSeptember 5, 2025
Certification dateSeptember 5, 2025
Mailing address4530 E Ray Rd Ste 190, Phoenix, AZ 85044-6098

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Banner Primary Care Physicians Arizona Llc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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