Provider Demographics
NPI:1376539882
Name:O'CONNELL, WILLIAM FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-5131
Mailing Address - Country:US
Mailing Address - Phone:215-423-2030
Mailing Address - Fax:215-423-2344
Practice Address - Street 1:2623 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-5131
Practice Address - Country:US
Practice Address - Phone:215-423-2030
Practice Address - Fax:215-423-2344
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0033660E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E64120Medicare UPIN