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NPI Code Detail

MEDICARE: MATTHEW JAMES O'CONNELL DPT

MEDICARE: MATTHEW JAMES O'CONNELL DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL.0013998CO
2225100000XPhysical TherapistP21737NC

General Provider Information

NPI Number : 1821447327
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JAMES O'CONNELL DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 503 OLDE WATERFORD WAY STE 205
Second Line :
City : LELAND
State : NC
Zip : 28451-4148
Country : US
Telephone Number : 910-399-4039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2016
Last Update Date : 11/24/2025

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