Individual
DR. KERRY TIMOTHY CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
323 MAIN ST, SACO, ME 04072-1514
(207) 284-4560
(207) 283-0309
Mailing address
323 MAIN ST, SACO, ME 04072-1514
(207) 284-4560
(207) 283-0309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT641
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001138
ANTHEM
ME
05
—
109280499
—
ME
01
—
8586932
CIGNA
ME
01
—
MNT1036
HARVARD PILGRIM
ME
Enumeration date
01/23/2007
Last updated
05/13/2008
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