Individual
BRIAN JOSEPH O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2555 COURT DR, SUITE 200, GASTONIA, NC 28054-2134
(704) 867-2141
(704) 867-2308
Mailing address
PO BOX 531797, ATLANTA, GA 30353-1797
(704) 834-2450
(704) 671-5331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102119
NC
363AS0400X
Surgical Physician Assistant
102119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360PA
—
SC
05
—
8101097
—
NC
Enumeration date
08/20/2006
Last updated
05/08/2017
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