Provider Demographics
NPI:1639159494
Name:O'NEAL, BRIAN ANDREW (DO , MPH)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANDREW
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:DO , MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2300 W STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-2360
Mailing Address - Country:US
Mailing Address - Phone:423-246-4961
Mailing Address - Fax:423-245-3136
Practice Address - Street 1:2300 W STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-2360
Practice Address - Country:US
Practice Address - Phone:423-246-4961
Practice Address - Fax:423-245-3136
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4739207N00000X
VAVA 01022011192083A0100X
VA0102201119207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine