Individual
JILL O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2587 COMMONS BLVD, SUITE 110, BEAVERCREEK, OH 45431-3841
(937) 424-5825
(937) 424-5829
Mailing address
2587 COMMONS BLVD, SUITE 110, BEAVERCREEK, OH 45431-3841
(937) 424-5825
(937) 458-0239
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50002879
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000494547
ANTHEM
OH
Enumeration date
02/11/2009
Last updated
04/15/2022
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