Individual
DR. MARK OWEN CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 297-4104
(570) 297-2066
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101253604
VA
208600000X
Surgery Physician
Primary
MD036027E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010468730001
—
PA
05
—
1770682643
—
VA
Enumeration date
09/21/2006
Last updated
08/13/2014
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