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Individual

DR. JEROME THOMAS O'CONNELL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191
(703) 670-1835
(703) 670-0827
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, DEPARTMENT OF PATHOLOGY, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
A63118
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D0058140
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD32177
DC
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
0101231713
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1861516718
VA
Enumeration date
03/18/2007
Last updated
08/01/2023
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