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General NPI Number Information
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NPI Number | 1831161124
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Entity Type | Individual
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Provider Name | TIMOTHY MICHAEL ONEILL PA
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 1649 LUCERNE ST SUITE A & B
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City | MINDEN
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State | NV
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Zip | 89423-4369
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Country | US
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Telephone | 775-782-1603
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Fax | 775-782-3417
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Provider Business Mailing Address
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Address Line | 1649 LUCERNE ST SUITE A & B
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City | MINDEN
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State | NV
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Zip | 89423-4369
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Country | US
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Telephone | 775-782-1603
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Fax | 775-782-3417
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA718
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License Number State | NV
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