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Individual

DR. JEFFREY LAWRENCE O'CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22250 PROVIDENCE DR, SUITE 203, SOUTHFIELD, MI 48075-4825
(248) 569-0155
(248) 569-5226
Mailing address
1795 STANLEY BLVD, BIRMINGHAM, MI 48009-1953
(248) 569-4898

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301085172
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4781079
MI
Enumeration date
05/18/2006
Last updated
01/15/2010
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