Basic Information
| Provider Information | |||||||||
| NPI: | 1275560666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'NEILL | ||||||||
| FirstName: | TERENCE | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF KENTUCKY GENERAL INTERNAL MED | ||||||||
| Address2: | 830 S. LIMESTONE | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY OF KENTUCKY GENERAL INTERNAL MED | ||||||||
| Address2: | 830 S. LIMESTONE | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592571000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 01/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 27683 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110110155 | 01 | KY | RAILROAD MEDICARE | OTHER | 1283881 | 01 | KY | UNITED MINE WORKERS ASSOC | OTHER | 64276835 | 05 | KY | MEDICAID | 022092900 | 01 | KY | BLACK LUNG INSURANCE | OTHER |