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General NPI Number Information
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NPI Number | 1417963372
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Entity Type | Individual
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Provider Name | NICHOLAS O'NEIL MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 6715 N 300 W
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City | LAFAYETTE
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State | IN
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Zip | 47906-9635
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Country | US
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Telephone | 765-427-4255
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Fax |
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Provider Business Mailing Address
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Address Line | 6715 N 300 W
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City | LAFAYETTE
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State | IN
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Zip | 47906-9635
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Country | US
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Telephone | 765-427-4255
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01032111
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License Number State | IN
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