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NPI Code Detail

MEDICARE: DR. TIMOTHY C. SPEARS DO

MEDICARE: DR. TIMOTHY C. SPEARS DO
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
1207Q00000XFamily Medicine Physician0523246KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3016668OTHERKSMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2106538OTHERKSMC PERFORMING PROVIDER #

General Provider Information

NPI Number : 1639173156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY C. SPEARS DO
Provider Business Mailing Address
First Line : 401 S WASHINGTON AVE
Second Line :
City : IOLA
State : KS
Zip : 66749-3256
Country : US
Telephone Number : 620-365-0151
Fax Number : 620-228-5440
Provider Business Practice Location Address
First Line : 401 S WASHINGTON AVE
Second Line :
City : IOLA
State : KS
Zip : 66749-3256
Country : US
Telephone Number : 620-365-0151
Fax Number : 620-228-5440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 06/16/2026

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