Healthcare Provider Details

I. General information

NPI: 1609940287
Provider Name (Legal Business Name): LINH NGUYEN O'CONNOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 18TH ST
COLUMBUS GA
31901-1524
US

IV. Provider business mailing address

920 18TH ST
COLUMBUS GA
31901-1524
US

V. Phone/Fax

Practice location:
  • Phone: 706-649-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number111530
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036093594
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2017-01424
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: