Provider Demographics
NPI:1609947993
Name:SPEER, JAROD E (MD)
Entity Type:Individual
Prefix:
First Name:JAROD
Middle Name:E
Last Name:SPEER
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:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:CHILDERSBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35044-0349
Mailing Address - Country:US
Mailing Address - Phone:256-378-3313
Mailing Address - Fax:256-378-5912
Practice Address - Street 1:34011 US HIGHWAY 280
Practice Address - Street 2:SUITE A
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-2128
Practice Address - Country:US
Practice Address - Phone:256-378-3313
Practice Address - Fax:256-378-5912
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL80252OtherCOMMERCIAL
ALP00392428OtherRAILROAD MEDICARE
AL51590048OtherBLUE CROSS BLUE SHIELD
AL200356379OtherTRICARE
AL1952484081Medicaid
AL80252OtherCOMMERCIAL
AL200356379OtherTRICARE