Provider Demographics
NPI:1134103252
Name:ONEIL, MICHAEL C JR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:ONEIL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2750 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2608
Mailing Address - Country:US
Mailing Address - Phone:541-673-8988
Mailing Address - Fax:541-672-8103
Practice Address - Street 1:2880 NW STEWART PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1206
Practice Address - Country:US
Practice Address - Phone:541-673-6777
Practice Address - Fax:541-440-3783
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD12556207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR223446Medicaid
OR223446Medicaid
C93446Medicare UPIN