Provider Demographics
NPI:1538196845
Name:SPEARS, HUBERT EARL JR (MD)
Entity type:Individual
Prefix:DR
First Name:HUBERT
Middle Name:EARL
Last Name:SPEARS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 REBEL DRIVE
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY
Mailing Address - State:MS
Mailing Address - Zip Code:38677-5223
Mailing Address - Country:US
Mailing Address - Phone:662-915-6550
Mailing Address - Fax:629-152-0226
Practice Address - Street 1:400 REBEL DRIVE
Practice Address - Street 2:
Practice Address - City:UNIVERSITY
Practice Address - State:MS
Practice Address - Zip Code:38677
Practice Address - Country:US
Practice Address - Phone:662-915-6550
Practice Address - Fax:662-915-2022
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS091892086X0206X, 208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00113324Medicaid
MS00113324Medicaid
MSB58986Medicare UPIN