Healthcare Provider Details

I. General information

NPI: 1427025386
Provider Name (Legal Business Name): AMY M O'CONNELL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6880 PERIMETER DR
DUBLIN OH
43016-2520
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-2805
  • Fax:
Mailing address:
  • Phone: 614-685-2805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50001584
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: