Healthcare Provider Details

I. General information

NPI: 1427636935
Provider Name (Legal Business Name): LUKE PATRICK O'CONNOR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
MORGANTOWN WV
26506-1200
US

IV. Provider business mailing address

727 FALLSGROVE DR APT 5032
ROCKVILLE MD
20850-7791
US

V. Phone/Fax

Practice location:
  • Phone: 304-293-2706
  • Fax: 304-293-2807
Mailing address:
  • Phone: 973-224-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number14271609-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: