Healthcare Provider Details

I. General information

NPI: 1265445233
Provider Name (Legal Business Name): JOHN H ONEILL JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD STE 5A43
NEWARK DE
19718-5854
US

IV. Provider business mailing address

200 HYGEIA DR STE 2300
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-0188
  • Fax:
Mailing address:
  • Phone: 302-623-7113
  • Fax: 302-623-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC2-0003347
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC20003347
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: