Individual
TIMOTHY ROGERS OCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 SOUTH NEW BALLAS ROAD, SUITE 6003B, SAINT LOUIS, MO 63141
(314) 991-2151
(314) 991-2742
Mailing address
621 SOUTH NEW BALLAS ROAD, SUITE 6003B, SAINT LOUIS, MO 63141
(314) 991-2151
(314) 991-2742
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
34187
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000004321
HUMANA GOLD CHOICE
—
01
—
240007863
RAILROAD MEDICARE
—
01
—
3066028001
CIGNA
—
01
—
6960V41192
CARE MANAGEMENT RESOURCE
—
01
—
A11093
MERCY HEALTH PLANS
—
Enumeration date
08/11/2006
Last updated
09/08/2008
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