Provider Demographics
NPI:1922019959
Name:OCONNOR, NEIL STEPHEN (DPM)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:STEPHEN
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MORGANTON BLVD SW STE E
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5243
Mailing Address - Country:US
Mailing Address - Phone:828-754-8886
Mailing Address - Fax:828-758-4640
Practice Address - Street 1:230 MORGANTON BLVD SW STE E
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5243
Practice Address - Country:US
Practice Address - Phone:828-754-8886
Practice Address - Fax:828-758-4640
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC253213E00000X
SC153213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT640918820Medicare PIN
T64091Medicare UPIN