MEDICARE: LYNN WESLEY O'NEAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	04-21364	KS

General Provider Information

NPI Number	:	1134168719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN WESLEY O'NEAL M.D.

Provider Business Mailing Address
First Line	:	2411 PRINCETON BLVD
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-1625
Country	:	US
Telephone Number	:	785-840-9718
Fax Number	:

Provider Business Practice Location Address
First Line	:	2411 PRINCETON BLVD STE 214
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-1625
Country	:	US
Telephone Number	:	785-424-0901
Fax Number	:	785-841-2765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/28/2024

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