Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 7039 | LA |
N | 213EG0000X | General Practice | 7039 | LA |
Y | 1223G0001X | General Practice | DD5351 | NM |
Y | 213EG0000X | General Practice | DD5351 | NM |
NPI | 1003310053 |
---|---|
Provider Name | Erin O'neal |
First Address | Albuquerque, NM 87102-4516 |
Second Address | Shreveport, LA 71105-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 22/02/2021 |