Provider Demographics
NPI:1396888616
Name:SPEER, GEORGE E (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:SPEER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12411 FLINT ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2119
Mailing Address - Country:US
Mailing Address - Phone:913-897-2186
Mailing Address - Fax:
Practice Address - Street 1:711 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3235
Practice Address - Country:US
Practice Address - Phone:816-561-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-20842207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100234780IMedicaid
KSP000471661OtherRR MCR GRP DH0925
KS10234780IMedicaid
KS0000107276OtherBCBS
KS0000107276OtherBCBS
KSP000471661OtherRR MCR GRP DH0925