Individual
KEVIN PAUL O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19415 DEERFIELD AVE STE 112, LEESBURG, VA 20176-8470
(703) 724-1195
(703) 724-4495
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101048160
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730173279
—
VA
01
—
340017904
RR MEDICARE
VA
01
—
340017905
RR MEDICARE
DC
Enumeration date
09/09/2005
Last updated
11/30/2022
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