Provider Demographics
NPI:1639234123
Name:SPEAR, STEVEN NOEL (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:NOEL
Last Name:SPEAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 S UPPER ST
Mailing Address - Street 2:SUITE 195
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2935
Mailing Address - Country:US
Mailing Address - Phone:859-259-3768
Mailing Address - Fax:859-281-9582
Practice Address - Street 1:535 S UPPER ST
Practice Address - Street 2:SUITE 195
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2935
Practice Address - Country:US
Practice Address - Phone:859-259-3768
Practice Address - Fax:859-281-9582
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1562DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77000891Medicaid
KYU93477Medicare UPIN
KY77000891Medicaid