Provider Demographics
NPI:1275560666
Name:O'NEILL, TERENCE W (MD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:W
Last Name:O'NEILL
Suffix:
Gender:M
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:UNIVERSITY OF KENTUCKY GENERAL INTERNAL MED
Mailing Address - Street 2:830 S. LIMESTONE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF KENTUCKY GENERAL INTERNAL MED
Practice Address - Street 2:830 S. LIMESTONE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27683207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY110110155OtherRAILROAD MEDICARE
KY1283881OtherUNITED MINE WORKERS ASSOC
KY64276835Medicaid
KY022092900OtherBLACK LUNG INSURANCE
KY022092900OtherBLACK LUNG INSURANCE