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General NPI Number Information
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NPI Number | 1477194488
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Entity Type | Organization
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Legal Business Name | JOE SPEER, MD, LLC
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 2950 S ELM PL STE 225
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City | BROKEN ARROW
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State | OK
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Zip | 74012-7825
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Country | US
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Telephone | 918-550-4446
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Fax | 918-550-8069
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Provider Business Mailing Address
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Address Line | 2950 S ELM PL STE 225
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City | BROKEN ARROW
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State | OK
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Zip | 74012-7825
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Country | US
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Telephone | 918-550-4446
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Fax | 918-550-8069
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Authorized Official
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Title or Position | PROPRIETOR
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Name | JOE B SPEER
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Credential | MD
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Telephone | 918-550-4446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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