Provider Demographics
NPI:1962630988
Name:O'QUINN, ANGEL JUSTICE (DO)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:JUSTICE
Last Name:O'QUINN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-0148
Mailing Address - Country:US
Mailing Address - Phone:270-298-7411
Mailing Address - Fax:270-298-3824
Practice Address - Street 1:44 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42343-9761
Practice Address - Country:US
Practice Address - Phone:270-276-9953
Practice Address - Fax:270-276-9958
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY03385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine