Provider Demographics
NPI:1043315385
Name:SPEARS, JOHN D (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:SPEARS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1616 SOUTHRIDGE DR
Mailing Address - Street 2:STE 202
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5677
Mailing Address - Country:US
Mailing Address - Phone:573-635-0401
Mailing Address - Fax:573-635-6715
Practice Address - Street 1:1616 SOUTHRIDGE DR
Practice Address - Street 2:STE 202
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5677
Practice Address - Country:US
Practice Address - Phone:573-635-0401
Practice Address - Fax:573-635-6715
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2010-12-09
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Provider Licenses
StateLicense IDTaxonomies
MO2003031159207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208747808Medicaid
MO208747808Medicaid
MO917551502Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL ID