Provider Demographics
NPI:1326274374
Name:O'CONNELL, JOHN PATRICK (BA, NBC-HIS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PATRICK
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:BA, NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BAYOU BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2671
Mailing Address - Country:US
Mailing Address - Phone:850-475-3027
Mailing Address - Fax:850-332-7892
Practice Address - Street 1:4300 BAYOU BLVD STE 2
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2671
Practice Address - Country:US
Practice Address - Phone:850-475-3027
Practice Address - Fax:850-332-7892
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3902237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist