Individual
DR. TIMOTHY ALLEN O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-3600
(573) 815-3716
Mailing address
PO BOX 10200, COLUMBIA, MO 65205-4003
(573) 815-9700
(573) 815-0700
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
R9H49
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106571
ANTHEM BCBS PIN
MO
01
—
10894794
CAQH PROVIDER ID
—
01
—
289639
HEALTHLINK PIN
—
01
—
3837
HEALTHCARE USA PIN
—
Enumeration date
11/04/2006
Last updated
07/08/2007
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