Provider Demographics
NPI:1790722999
Name:SPEIGHTS, STEVEN EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EDWIN
Last Name:SPEIGHTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 RIVER OAKS DR STE 103
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9531
Mailing Address - Country:US
Mailing Address - Phone:601-948-6540
Mailing Address - Fax:601-948-6518
Practice Address - Street 1:1040 RIVER OAKS DR STE 103
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9531
Practice Address - Country:US
Practice Address - Phone:601-948-6540
Practice Address - Fax:601-948-6518
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023691207V00000X, 207VF0040X, 207VG0400X, 208800000X, 2088F0040X
MS13911207V00000X, 207VG0400X, 208800000X, 2088F0040X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS334419YX5TMedicaid
MS160046013OtherRAILROAD MEDICARE
MS5850547OtherAETNA
MS5850547OtherAETNA
MS160000425Medicare ID - Type Unspecified