Basic Information
Provider Information | |||||||||
NPI: | 1528396611 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | WILLIAM E OCONNOR | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1030 PRESIDENT AVE | ||||||||
Address2: | SUITE 124 | ||||||||
City: | FALL RIVER | ||||||||
State: | MA | ||||||||
PostalCode: | 027205923 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5086784244 | ||||||||
FaxNumber: | 5082356665 | ||||||||
Practice Location | |||||||||
Address1: | 1030 PRESIDENT AVE | ||||||||
Address2: | SUITE 124 | ||||||||
City: | FALL RIVER | ||||||||
State: | MA | ||||||||
PostalCode: | 027205923 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5086784244 | ||||||||
FaxNumber: | 5082356665 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/01/2009 | ||||||||
LastUpdateDate: | 07/14/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | BURKE | ||||||||
AuthorizedOfficialFirstName: | DONA | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | BILLER | ||||||||
AuthorizedOfficialTelephone: | 5086784244 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MRS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 7012 | RI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology |   | 207Y00000X | 56708 | MA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology |   |
No ID Information.