Provider Demographics
NPI:1699783712
Name:ONARO, NELSON C (DO)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:C
Last Name:ONARO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-1006
Mailing Address - Country:US
Mailing Address - Phone:918-423-5916
Mailing Address - Fax:918-423-5967
Practice Address - Street 1:320 E DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5512
Practice Address - Country:US
Practice Address - Phone:918-423-5916
Practice Address - Fax:918-423-5967
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDEPT OF LABOROther610872700
OK100069700CMedicaid
AR158744003Medicaid
249423903Medicare PIN
OKDEPT OF LABOROther610872700