Organization
HENDERSON ORTHOPAEDIC MEDICAL GROUP, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB M O'NEILL M.D. (PRESIDENT)
(270) 830-8032
Entity
Organization
Contact information
Practice address
471 KLUTEY PARK PLAZA DR, HENDERSON, KY 42420-3347
(270) 830-8032
(270) 830-8132
Mailing address
471 KLUTEY PARK PLAZA DR, HENDERSON, KY 42420-3347
(270) 830-8032
(270) 830-8132
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65927352
—
KY
Enumeration date
07/14/2005
Last updated
07/21/2022
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