O'Connell, Jerome Thomas

O'Connell, Jerome Thomas is an sole proprietor health care provider with primary practice located at 2300 Opitz Blvd , Woodbridge VA 22191. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine is his primary health care specialty. O'Connell, Jerome Thomas can be contacted via phone (703) 670-1835.

Contact Information

Primary practice address
2300 Opitz Blvd Woodbridge VA 22191
Phone: (703) 670-1835
Fax: (703) 670-0827
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD32177 District of Columbia
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X A63118 California
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X D0058140 Maryland
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X 0101231713 Virginia

Profile Details

NPI number 1861516718
LBN Legal business name O'Connell, Jerome Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 18th, 2007
Last updated Aug 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861516718 NPPES
Virginia MEDICAID 1861516718

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