Provider Demographics
NPI:1093447401
Name:O'NEAL, NILA S (CPT)
Entity Type:Individual
Prefix:MS
First Name:NILA
Middle Name:S
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:JENKINSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30234-2404
Mailing Address - Country:US
Mailing Address - Phone:404-502-3932
Mailing Address - Fax:
Practice Address - Street 1:737 S HILL ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4830
Practice Address - Country:US
Practice Address - Phone:404-502-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-26
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program