Provider Demographics
NPI:1184685950
Name:O'NEAL, BARRON JOHNS (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRON
Middle Name:JOHNS
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2210 LINE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2152
Mailing Address - Country:US
Mailing Address - Phone:318-221-9671
Mailing Address - Fax:318-425-2343
Practice Address - Street 1:2210 LINE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2152
Practice Address - Country:US
Practice Address - Phone:318-221-9671
Practice Address - Fax:318-425-2343
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA014595208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1385336Medicaid
LA1385336Medicaid
LAB65257Medicare UPIN