Organization
ROBERT J MCCONNELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J MCCONNELL D.O. (OWNER)
(937) 890-6252
Entity
Organization
Contact information
Practice address
107 KENBROOK DR, VANDALIA, OH 45377-2427
(937) 890-6252
(937) 890-1725
Mailing address
P.O. BOX 235, VANDALIA, OH 45377-2427
(937) 890-6252
(937) 890-1725
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1569
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0877761
—
OH
01
—
DP5373
RAILROAD MEDICARE
OH
Enumeration date
10/22/2007
Last updated
11/01/2010
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