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NPI Code Detail

MEDICARE: DR. REX P. SPEAR MD

MEDICARE: DR. REX P. SPEAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician7302MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235191388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REX P. SPEAR MD
Provider Business Mailing Address
First Line : 1648 ELLIS ST STE 201
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-8811
Country : US
Telephone Number : 406-587-8631
Fax Number : 406-587-1343
Provider Business Practice Location Address
First Line : 1648 ELLIS ST STE 201
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-8811
Country : US
Telephone Number : 406-587-8631
Fax Number : 406-587-1343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 09/21/2020

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