Provider Demographics
NPI:1083474019
Name:PATRICK OCONNELL DO PLLC
Entity Type:Organization
Organization Name:PATRICK OCONNELL DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER / AUITHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-513-4100
Mailing Address - Street 1:42450 W 12 MILE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3030
Mailing Address - Country:US
Mailing Address - Phone:248-513-4100
Mailing Address - Fax:248-513-4105
Practice Address - Street 1:42450 W 12 MILE RD STE 315
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3030
Practice Address - Country:US
Practice Address - Phone:248-513-4100
Practice Address - Fax:248-513-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty