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General NPI Number Information
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NPI Number | 1215907787
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Entity Type | Individual
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Provider Name | LEONARD T ONEILL MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 535 S BURDICK ST
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City | KALAMAZOO
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State | MI
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Zip | 49007-5294
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Country | US
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Telephone | 269-341-8822
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Fax | 269-341-7518
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Provider Business Mailing Address
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Address Line | 535 S BURDICK ST
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City | KALAMAZOO
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State | MI
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Zip | 49007-5294
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Country | US
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Telephone | 269-341-8822
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Fax | 269-341-7518
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301046136
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License Number State | MI
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