Individual
MR. JOHN JOSEPH O CONNOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
900 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4417
(336) 724-6871
(336) 724-6871
Mailing address
900 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4417
(336) 724-6871
(336) 724-6871
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
PNO695
NC
224P00000X
Prosthetist
Primary
PNO695
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0495 B
BLUE CROSS BLUE SHIELD
NC
05
—
7700250
—
NC
Enumeration date
07/29/2005
Last updated
01/08/2008
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