Individual
THOMAS O'CONNELL
Active
Individual
THOMAS O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33055
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044596
ANTHEM
—
01
—
021036000
FEDERAL BLACK LUNG
—
01
—
0404223
UNITED HEALTHCARE
—
05
—
2466479
—
OH
01
—
310674100
US DEPT OF LABOR
—
01
—
50006692
PASSPORT
—
05
—
64330558
—
KY
01
—
872928
AETNA
—
01
—
P00935617
RAIL ROAD MEDICARE
KY
Enumeration date
08/22/2005
Last updated
08/01/2011
Update your record
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