Provider Demographics
NPI:1699787036
Name:SPEER, MARCUS GAYLON (P D)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:GAYLON
Last Name:SPEER
Suffix:
Gender:M
Credentials:P D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6004 EAGLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-5778
Mailing Address - Country:US
Mailing Address - Phone:501-835-7603
Mailing Address - Fax:501-835-3025
Practice Address - Street 1:7311 N HILLS BLVD
Practice Address - Street 2:SUITE NO. 3
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72116-5355
Practice Address - Country:US
Practice Address - Phone:501-835-7775
Practice Address - Fax:501-835-3025
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD05156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist