Provider Demographics
NPI:1164876918
Name:SPEIRS, JOSHUA NELSON (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:NELSON
Last Name:SPEIRS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 N 300 W STE 302
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6124
Mailing Address - Country:US
Mailing Address - Phone:801-357-4470
Mailing Address - Fax:801-357-4473
Practice Address - Street 1:1157 N 300 W STE 302
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6124
Practice Address - Country:US
Practice Address - Phone:801-357-4470
Practice Address - Fax:801-357-4473
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA151041207X00000X
UT12793565-1205207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery