Provider Demographics
NPI:1083615165
Name:O'NEILL, JAMES E (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 STANLEY GAULT PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4197
Mailing Address - Country:US
Mailing Address - Phone:502-253-1035
Mailing Address - Fax:502-253-1037
Practice Address - Street 1:1780 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1400
Practice Address - Country:US
Practice Address - Phone:859-276-4476
Practice Address - Fax:859-276-4478
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-11-10
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Provider Licenses
StateLicense IDTaxonomies
KY17456207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64174568Medicaid
KYC70451Medicare UPIN
KY64174568Medicaid