Individual
RICHARD PHILLIP OCONNOR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4070 LAKE DR SE, STE 201, GRAND RAPIDS, MI 49546-8294
(616) 774-8200
(616) 774-0304
Mailing address
PO BOX 150185, GRAND RAPIDS, MI 49515-0185
(616) 866-2539
(616) 866-3135
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
RO044045
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044045
MEDICAL LICENSE
MI
05
—
3371432
—
MI
Enumeration date
08/31/2006
Last updated
09/26/2008
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