Timothy Isamu O'connor, MD | |
55 W Tietan St, Walla Walla, WA 99362-4445 | |
(509) 525-3720 | |
Not Available |
Full Name | Timothy Isamu O'connor |
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Gender | Male |
Speciality | Pediatrics |
Location | 55 W Tietan St, Walla Walla, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073856043 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ML60368579 (Washington) | Secondary |
208000000X | Pediatrics | MD60658842 (Washington) | Primary |
Entity Name | Privia Medical Group Washington Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780658419 PECOS PAC ID: 2264320837 Enrollment ID: O20040309000126 |
Mailing Address | Practice Location Address |
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Timothy Isamu O'connor, MD 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 | Timothy Isamu O'connor, MD 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 |
Rebekah Dickman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 | |
Donald K Ashley, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1111 S 2nd Ave, Walla Walla, WA 99362 Phone: 509-522-0100 Fax: 509-527-8010 | |
Dr. Alison E Kirby, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1578 | |
Kristin Marie Satterfield, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1111 S 2nd Ave, Walla Walla, WA 99362 Phone: 509-527-8152 | |
Trent D. Rogers, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 55 West Tietan Street, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 | |
Dr. Christopher P Hall, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1592 |