Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 1.057093-DO | CT |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 1.057093-DO | CT |
NPI | 1851482616 |
---|---|
Provider Name | Dr. Joule O'connor |
First Address | Virginia Beach, VA 23462-1781 |
Second Address | Norfolk, VA 23510-1065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 29/10/2020 |