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NPI Code Detail

MEDICARE: MARCUS SPEAR

MEDICARE: MARCUS SPEAR
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
1103K00000XBehavior Analyst1-24-77666IN

General Provider Information

NPI Number : 1629667209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS SPEAR
Provider Business Mailing Address
First Line : 15755 N POINTE BLVD
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4388
Country : US
Telephone Number : 317-802-7447
Fax Number : 317-802-7325
Provider Business Practice Location Address
First Line : 15755 N POINTE BLVD
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4388
Country : US
Telephone Number : 317-802-7447
Fax Number : 317-802-7325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2021
Last Update Date : 12/26/2024

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Directions to “ MARCUS SPEAR ” Practice Location

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