Individual
JOHN CHARLES O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
811 CORPORATE DR STE 101, LEXINGTON, KY 40503-5408
(859) 296-2847
(859) 296-0796
Mailing address
PO BOX 911008, LEXINGTON, KY 40591-1008
(859) 296-2847
(859) 296-0796
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
KY36541
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64019656
—
KY
Enumeration date
12/30/2006
Last updated
07/08/2007
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