Provider Demographics
NPI:1114181484
Name:O'NEILL, ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE#2640
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-258-7788
Mailing Address - Fax:702-258-7787
Practice Address - Street 1:8930 W SUNSET RD
Practice Address - Street 2:SUITE#300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5008
Practice Address - Country:US
Practice Address - Phone:702-258-7788
Practice Address - Fax:702-258-7787
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08019300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery