Healthcare Provider Details

I. General information

NPI: 1790722999
Provider Name (Legal Business Name): STEVEN EDWIN SPEIGHTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 RIVER OAKS DR STE 103
FLOWOOD MS
39232-9531
US

IV. Provider business mailing address

1040 RIVER OAKS DR STE 103
FLOWOOD MS
39232-9531
US

V. Phone/Fax

Practice location:
  • Phone: 601-948-6540
  • Fax: 601-948-6518
Mailing address:
  • Phone: 601-948-6540
  • Fax: 601-948-6518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number00023691
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number13911
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number00023691
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number00023691
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number13911
License Number StateMS
# 6
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number13911
License Number StateMS
# 7
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number00023691
License Number StateAL
# 8
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number00023691
License Number StateAL
# 9
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number13911
License Number StateMS
# 10
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number13911
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: