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Individual

ROBERT J MCCONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
107 KENBROOK DR, VANDALIA, OH 45377-2427
(937) 890-1725
(937) 890-1725
Mailing address
P.O. BOX 235, VANDALIA, OH 45377-2427
(937) 890-1725
(937) 890-1725

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
OH34001569
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000003522
BC/BS
OH
05
0020391
OH
01
010047653
RAILROAD MEDICARE
OH
01
A14298
UPIN
OH
Enumeration date
11/16/2005
Last updated
03/07/2023
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