Healthcare Provider Details

I. General information

NPI: 1285895623
Provider Name (Legal Business Name): KEITH W SPEARS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 NORTHWOODS DR - MAIL STOP 32800A HEALTHPARTNERS ARDEN HILLS CLINIC
ARDEN HILLS MN
55112-6974
US

IV. Provider business mailing address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

V. Phone/Fax

Practice location:
  • Phone: 651-523-8500
  • Fax: 651-523-8584
Mailing address:
  • Phone: 210-706-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number54274
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: