Individual
BRENDAN O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001-1383
(928) 774-5074
(928) 779-0884
Mailing address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001-1383
(928) 774-5074
(928) 779-0884
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
49416
AZ
207N00000X
Dermatology Physician
50202
CO
207N00000X
Dermatology Physician
MD450182
PA
207ND0101X
MOHS-Micrographic Surgery Physician
49416
AZ
207ND0900X
Dermatopathology Physician
49416
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920324
—
AZ
Enumeration date
07/03/2008
Last updated
12/22/2021
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