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NPI Code Detail

MEDICARE: DR. ELLIS HILTON O'NEAL MD

MEDICARE: DR. ELLIS HILTON O'NEAL MD
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
1207P00000XEmergency Medicine Physician09646MS

General Provider Information

NPI Number : 1407800048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLIS HILTON O'NEAL MD
Provider Business Mailing Address
First Line : PO BOX 4739
Second Line :
City : GREENVILLE
State : MS
Zip : 38704-4739
Country : US
Telephone Number : 662-725-2749
Fax Number : 662-725-2741
Provider Business Practice Location Address
First Line : 1400 E UNION ST
Second Line :
City : GREENVILLE
State : MS
Zip : 38703-3246
Country : US
Telephone Number : 662-378-3783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 04/22/2014

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