Provider Demographics
NPI:1992903421
Name:O'NEAL, BURKE L (MD)
Entity type:Individual
Prefix:
First Name:BURKE
Middle Name:L
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16710 NE 226TH CIR
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4749
Mailing Address - Country:US
Mailing Address - Phone:208-890-6251
Mailing Address - Fax:
Practice Address - Street 1:16710 NE 226TH CIR
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4749
Practice Address - Country:US
Practice Address - Phone:208-890-6251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-11275207L00000X
UT7960639-1205207L00000X
WAMD.60200750207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology