Individual
DR. KEVIN W MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST, STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01076419A
IN
2086S0102X
Surgical Critical Care Physician
01076419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001013079
ANTHEM BCBS
—
01
—
01076419
INDIANA STATE LICENSE
IN
05
—
201351330
—
IN
05
—
7100409330
—
KY
Enumeration date
05/30/2005
Last updated
03/05/2024
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