Provider Demographics
NPI:1154313450
Name:O'NEIL, CHRIS MANSEL (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:MANSEL
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-784-5545
Mailing Address - Fax:570-245-0240
Practice Address - Street 1:6850 LOWS RD
Practice Address - Street 2:STE 325
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8708
Practice Address - Country:US
Practice Address - Phone:570-784-5545
Practice Address - Fax:570-245-0240
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009967L207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2K3233OtherMEDICARE (FAMILY PRACTICE CENTER PC)
PA0018054620002Medicaid
PA1805462Medicaid