Individual
MR. JACK ONEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
15739 PROFESSIONAL PLAZA, HAMMOND, LA 70403-1452
(985) 345-6000
(985) 345-4498
Mailing address
15739 PROFESSIONAL PLAZA, HAMMOND, LA 70403-1452
(985) 345-6000
(985) 345-4498
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00095
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06552
BCBS
LA
01
—
11655
BCBS
LA
01
—
1449819
UNITED HEALTH CARE
LA
01
—
32005900
ACS OWCP
LA
01
—
5716136
FIRST HEALTH
LA
01
—
684200
ACN
LA
01
—
720678856
OGB
LA
Enumeration date
04/23/2007
Last updated
02/17/2012
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