Individual
DR. JOHN CARROLL MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4725 WELLINGTON ST, GREENVILLE, TX 75401-4945
(903) 450-4242
Mailing address
4725 WELLINGTON ST, GREENVILLE, TX 75401-4945
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E8702
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1218752-02
—
TX
Enumeration date
06/28/2006
Last updated
07/16/2007
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