Individual
BRIAN J O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1707 W CHARLESTON BLVD STE 160, LAS VEGAS, NV 89102-2354
(702) 671-5150
(702) 671-2259
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3050
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2013-02230
NC
208600000X
Surgery Physician
268463
MA
2086S0127X
Trauma Surgery Physician
Primary
20465
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730494741
—
NC
01
—
1832R
BCBS NC
NC
Enumeration date
08/13/2010
Last updated
05/26/2021
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