Provider Demographics
NPI:1871672204
Name:SPEIGHT, ONITA L (MD)
Entity Type:Individual
Prefix:
First Name:ONITA
Middle Name:L
Last Name:SPEIGHT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 122205
Mailing Address - Street 2:DEPT 2205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2205
Mailing Address - Country:US
Mailing Address - Phone:337-494-2772
Mailing Address - Fax:337-494-2928
Practice Address - Street 1:2770 3RD AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8994
Practice Address - Country:US
Practice Address - Phone:337-494-6800
Practice Address - Fax:337-494-6811
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2021-02-09
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Provider Licenses
StateLicense IDTaxonomies
LAL010959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1124605Medicaid
LA1124605Medicaid
LAB65764Medicare UPIN