Provider Demographics
NPI:1386860377
Name:ONOR, GABRIEL I SR (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:I
Last Name:ONOR
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:LA
Mailing Address - Zip Code:70748
Mailing Address - Country:US
Mailing Address - Phone:225-634-0108
Mailing Address - Fax:225-634-0522
Practice Address - Street 1:4502 HIGHWAY 951
Practice Address - Street 2:EASTERN LA MENTAL HEALTH SYSTEM
Practice Address - City:JACKSON
Practice Address - State:LA
Practice Address - Zip Code:70748
Practice Address - Country:US
Practice Address - Phone:225-634-0224
Practice Address - Fax:225-634-0213
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LALA023809207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57047Medicaid
LA57047Medicaid
LA4A060Medicare ID - Type Unspecified