Individual ProviderKevin O'NealInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address5501 N Portland Ave, Oklahoma City, OK 73112-2074(405) 604-4577PECOS EnrollmentBased on the most recent information from CMS, provider Kevin O'Neal is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1548394752Provider TypeIndividualFull NameO'Neal, KevinCredentialD.O.GenderMaleSole ProprietorNoEnumeration Date3/16/2007Last Updated1/26/2021Contact InformationPractice LocationPractice Address5501 N Portland Ave, Oklahoma City, OK 73112-2074Phone(405) 604-4577Fax(405) 604-4578Mailing LocationMailing Address5300 N Independence Ave Ste 280, Oklahoma City, OK 73112-5555Phone(405) 604-4577Fax(405) 604-4578Provider TaxonomiesCodeDescriptionLicenseCode207RP1001XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4544OklahomaProvider IdentifiersIDDescriptionIssuerID200528200ADescriptionMedicaidIssuerUnlistedOklahoma