Healthcare Provider Details

I. General information

NPI: 1245975713
Provider Name (Legal Business Name): MOLLY R O'NEIL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 N MECKLENBURG AVE
SOUTH HILL VA
23970-4080
US

IV. Provider business mailing address

PO BOX 980401
RICHMOND VA
23298-0401
US

V. Phone/Fax

Practice location:
  • Phone: 434-447-3151
  • Fax:
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0102209203
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102209203
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: