Individual
JACOB M O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
(812) 488-4669
Mailing address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
(812) 488-4669
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01048828A
IN
207X00000X
Orthopaedic Surgery Physician
30896
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200830150
—
IN
Enumeration date
06/23/2005
Last updated
10/30/2013
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