Provider Demographics
NPI:1942892369
Name:O'CONNOR, WILLIAM CHARLES JR (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:O'CONNOR
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:11301 GOLF LINKS DR N STE 203
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8014
Mailing Address - Country:US
Mailing Address - Phone:704-321-3376
Mailing Address - Fax:
Practice Address - Street 1:11301 GOLF LINKS DR N STE 203
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8014
Practice Address - Country:US
Practice Address - Phone:704-321-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC001011006363A00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology