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General NPI Number Information
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NPI Number | 1548775885
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Entity Type | Individual
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Provider Name | DAVID WAYNE SPEARS RPH
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Gender | Male
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 10460 NORRIS FERRY ROAD
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City | SHREVEPORT
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State | LA
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Zip | 71106
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Country | US
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Telephone | 318-798-5624
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Fax |
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Provider Business Mailing Address
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Address Line | 635 RATCLIFF ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-4909
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Country | US
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Telephone | 318-349-6490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10314
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License Number State | LA
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