Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101043878 | VA |
NPI | 1154340180 |
---|---|
Provider Name | Dr. Patrick W O'connell |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Virginia Beach, VA 23454-3004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 15/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6409644 | (05) | VA |
D40774 | (02) | VA |