Provider Demographics
NPI:1689715013
Name:O'NEAL, CATHERINE SMITH (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:SMITH
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84460
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-4460
Mailing Address - Country:US
Mailing Address - Phone:225-526-0018
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5247 DIDESSE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9153
Practice Address - Country:US
Practice Address - Phone:225-374-0082
Practice Address - Fax:225-765-9150
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026433207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1390259Medicaid
LA1390259Medicaid