Healthcare Provider Details

I. General information

NPI: 1780691261
Provider Name (Legal Business Name): DANIEL J. O'CONNELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 WASHINGTON ST
FOXBORO MA
02035-1021
US

IV. Provider business mailing address

18 WASHINGTON ST
FOXBORO MA
02035-1021
US

V. Phone/Fax

Practice location:
  • Phone: 508-698-0011
  • Fax: 508-698-5373
Mailing address:
  • Phone: 508-698-0011
  • Fax: 508-698-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number45841
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: