Individual
DR. SIGNE H. O'NEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049703
GA
207Q00000X
Family Medicine Physician
P6880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000963135L
—
GA
05
—
00963135A
—
GA
01
—
GA2331
SC MEDICAID
GA
05
—
GA2331
—
GA
Enumeration date
09/13/2006
Last updated
01/07/2019
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