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General NPI Number Information
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NPI Number | 1265603021
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Entity Type | Organization
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Legal Business Name | JOHN J. O'CONNOR MD PC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 11125 ROCKVILLE PIKE SUITE 308
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City | ROCKVILLE
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State | MD
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Zip | 20852-3142
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Country | US
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Telephone | 301-881-5167
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Fax | 301-881-3473
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Provider Business Mailing Address
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Address Line | PO BOX 341589
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City | BETHESDA
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State | MD
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Zip | 20827-1589
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Country | US
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Telephone | 301-881-5167
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Fax | 301-881-3473
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN J O'CONNOR
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Credential | MD
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Telephone | 301-881-5167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0009499
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License Number State | MD
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