Individual
MICHAEL R O'NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 SHELBY SPEIGHTS DR, PURVIS, MS 39475-4151
(601) 794-8065
(601) 794-5650
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 794-8065
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07041
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010767
—
MS
01
—
080021153
RAILROAD MEDICARE
MS
05
—
1502308
—
LA
01
—
2292726
AMERICAN ADMIN GROUP
MS
Enumeration date
08/21/2006
Last updated
07/08/2020
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