Healthcare Provider Details

I. General information

NPI: 1578504098
Provider Name (Legal Business Name): PATRICK O'NEILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 LEE STREET, E SUITE 208
CHARLESTON WV
25301
US

IV. Provider business mailing address

400 ASSOCIATION DRIVE SUITE 102
CHARLESTON WV
25311
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-7278
  • Fax: 304-388-7280
Mailing address:
  • Phone: 304-760-7536
  • Fax: 304-760-7540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number32959
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number32959
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number32959
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: