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NPI Code Detail

MEDICARE: LINH NGUYEN O'CONNOR MD

MEDICARE: LINH NGUYEN O'CONNOR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician036093594IL
2208600000XSurgery Physician2017-01424NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2400280OTHERILGROUP MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609940287
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINH NGUYEN O'CONNOR MD
Provider Business Mailing Address
First Line : 2555 COURT DR STE 450
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2191
Country : US
Telephone Number : 704-671-7652
Fax Number : 704-671-7656
Provider Business Practice Location Address
First Line : 2555 COURT DR STE 450
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2191
Country : US
Telephone Number : 704-671-7652
Fax Number : 704-671-7656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 02/06/2026

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Directions to “ LINH NGUYEN O'CONNOR MD” Practice Location

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