Individual
KATHY JEAN O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5150 JOURNAL CENTER BLVD NE FL 2, ALBUQUERQUE, NM 87109-5900
(505) 262-3212
(505) 232-1532
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-3212
(505) 232-1532
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27775
AZ
207R00000X
Internal Medicine Physician
Primary
MD2014-0587
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480088
—
AZ
01
—
804682
CMS
NM
05
—
90558235
—
NM
Enumeration date
08/11/2006
Last updated
09/11/2019
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