Provider Demographics
NPI:1750467205
Name:SPAIGHT, DEBORAH A (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:SPAIGHT
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 1:4979 TOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2283
Mailing Address - Country:US
Mailing Address - Phone:401-789-6492
Mailing Address - Fax:401-789-5524
Practice Address - Street 1:4979 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-2283
Practice Address - Country:US
Practice Address - Phone:401-789-6492
Practice Address - Fax:401-789-5524
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI11052208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI458315OtherTUFTS
RIDS47941Medicaid
RI21696OtherBLUE CROSS/BLUE SHIELD
RI12-02976OtherUNITED HEALTHCARE
RI410105OtherBC/BS BLUE CHIP
RI21696OtherBLUE CROSS/BLUE SHIELD
RI458315OtherTUFTS