Individual
JESSE LYNN SPEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 N ILLINOIS ST, SUITE 595, CARMEL, IN 46032-3008
(317) 688-5522
(317) 688-5533
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01061024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000679049
ANTHEM BCBS (SVMG)
IN
05
—
200921080
—
IN
Enumeration date
11/06/2006
Last updated
09/03/2020
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