Provider Demographics
NPI:1982037255
Name:RUPARD & SPEAKE PEDIATRIC GROUP PLLC
Entity Type:Organization
Organization Name:RUPARD & SPEAKE PEDIATRIC GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-685-8668
Mailing Address - Street 1:2839 HIGHWAY 231 N
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7447
Mailing Address - Country:US
Mailing Address - Phone:931-685-8668
Mailing Address - Fax:
Practice Address - Street 1:2839 HIGHWAY 231 N
Practice Address - Street 2:SUITE 107
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7447
Practice Address - Country:US
Practice Address - Phone:931-685-8668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty