Individual
MR. MICAH BRITT SPEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
2000 HWY 25B. N., SUITE C-1, HEBER SPRINGS, AR 72543
(501) 206-3500
(501) 206-3505
Mailing address
5402 BRANTFORD AVE., MEMPHIS, TN 38120-2440
(901) 767-3665
(501) 206-3505
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49849
BLUE CROSS BLUE SHIELD
AR
Enumeration date
06/13/2005
Last updated
01/04/2008
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