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General NPI Number Information
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NPI Number | 1699787036
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Entity Type | Individual
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Provider Name | MARCUS GAYLON SPEER P. D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7311 N HILLS BLVD SUITE NO. 3
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City | SHERWOOD
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State | AR
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Zip | 72116-5355
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Country | US
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Telephone | 501-835-7775
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Fax | 501-835-3025
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Provider Business Mailing Address
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Address Line | 6004 EAGLE CREEK RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-5778
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Country | US
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Telephone | 501-835-7603
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Fax | 501-835-3025
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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 | PD05156
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License Number State | AR
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