Provider Demographics
NPI:1326003245
Name:O'NEAL, JOHN W (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 MARGARET AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802
Mailing Address - Country:US
Mailing Address - Phone:812-235-9752
Mailing Address - Fax:812-232-4625
Practice Address - Street 1:2111 E MARGARET DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3336
Practice Address - Country:US
Practice Address - Phone:812-235-9752
Practice Address - Fax:812-232-4625
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000513A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5326290OtherAETNA
IN7947877001OtherCIGNA PAL NUMBER
IN000000083759OtherANTHEM BCBS
IN5326290OtherAETNA
INU29970Medicare UPIN