Provider Demographics
NPI:1669433991
Name:O'NEAL, NANCY CAROLYN (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:CAROLYN
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 SOUTHVIEW TER
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9367
Mailing Address - Country:US
Mailing Address - Phone:541-261-1122
Mailing Address - Fax:
Practice Address - Street 1:3932 SOUTHVIEW TER
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9367
Practice Address - Country:US
Practice Address - Phone:541-261-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27835208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR4898020OtherBLUE CROSS
OR241576Medicaid
OR139572OtherMEDICARE
ORG70177Medicare UPIN