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NPI Code Detail

MEDICARE: MRS. MARJORIE HANNON O'NEIL DMD

MEDICARE: MRS. MARJORIE HANNON O'NEIL DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryLNO 5929AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2011846OTHERALMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31063439065OTHERALPAYEE NPI GROUP NUMBER

General Provider Information

NPI Number : 1558624973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARJORIE HANNON O'NEIL DMD
Provider Business Mailing Address
First Line : PO BOX 2867
Second Line :
City : MOBILE
State : AL
Zip : 36652-2867
Country : US
Telephone Number : 251-690-8158
Fax Number : 251-544-2188
Provider Business Practice Location Address
First Line : 4547 SAINT STEPHENS RD
Second Line :
City : EIGHT MILE
State : AL
Zip : 36613-3563
Country : US
Telephone Number : 251-456-1399
Fax Number : 251-456-0079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2012
Last Update Date : 06/20/2012

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Directions to “ MRS. MARJORIE HANNON O'NEIL DMD” Practice Location

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