Provider Demographics
NPI:1851391650
Name:OCONNOR, PATRICK ST JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ST JOHN
Last Name:OCONNOR
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 1:3880 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3504
Mailing Address - Country:US
Mailing Address - Phone:239-659-3937
Mailing Address - Fax:
Practice Address - Street 1:3880 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3504
Practice Address - Country:US
Practice Address - Phone:239-659-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF-2377207W00000X
FLME128222207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742184907OtherAETNA
TX742184907OtherHUMANA
TX126148906Medicaid
TX126148907Medicaid
TXC19986Medicare UPIN
TX126148907Medicaid
TX8474B9Medicare PIN
TX8K1990Medicare PIN