1730463225 NPI number — MRS. MEGHAN O'CONNOR MCCHESNEY PA

Table of content: MRS. MEGHAN O'CONNOR MCCHESNEY PA (NPI 1730463225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730463225 NPI number — MRS. MEGHAN O'CONNOR MCCHESNEY PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCHESNEY
Provider First Name:
MEGHAN
Provider Middle Name:
O'CONNOR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'CONNOR
Provider Other First Name:
MEGHAN
Provider Other Middle Name:
ALICE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730463225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5671 PEACHTREE DUNWOOD RD, NE
Provider Second Line Business Mailing Address:
SUITE 520
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-843-5801
Provider Business Mailing Address Fax Number:
678-843-7657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5671 PEACHTREE DUNWOOD RD, NE
Provider Second Line Business Practice Location Address:
SUITE 520
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-843-5801
Provider Business Practice Location Address Fax Number:
678-843-7657
Provider Enumeration Date:
10/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  006186 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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