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General NPI Number Information
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NPI Number | 1720028186
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Entity Type | Individual
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Provider Name | JOHN J O'CONNELL III DO
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 2614 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4311
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Country | US
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Telephone | 850-215-3000
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Fax | 850-215-3150
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Provider Business Mailing Address
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Address Line | PO BOX 735911
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City | DALLAS
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State | TX
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Zip | 75373-5911
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Country | US
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Telephone | 972-675-7266
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Fax | 972-607-4655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8509
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License Number State | FL
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