Provider Demographics
NPI:1407838667
Name:SPEERS, DON JR (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:SPEERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:72 GRISTMILL RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3150
Mailing Address - Country:US
Mailing Address - Phone:732-886-2541
Mailing Address - Fax:
Practice Address - Street 1:1075 STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:FT. MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07703
Practice Address - Country:US
Practice Address - Phone:732-532-1341
Practice Address - Fax:732-532-3452
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-25745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BS7062297OtherDEA REGISTRATION
BS7062297OtherDEA REGISTRATION