Individual
KEVIN P. O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
Mailing address
175 LANG DR, NORTH KINGSTOWN, RI 02852-3415
(401) 294-6915
(401) 767-1623
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD08915
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29622-3
BLUECROSS BLUESHIELD
RI
05
—
7004850
—
RI
Enumeration date
02/20/2006
Last updated
07/08/2007
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