Organization
KEVIN T OCONNOR DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN T OCONNOR DO (PRESIDENT)
(989) 584-6801
Entity
Organization
Contact information
Practice address
421 S BALDWIN ST, GREENVILLE, MI 48838-2102
(989) 584-6801
Mailing address
PO BOX 326, CARSON CITY, MI 48811-0326
(989) 584-6801
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101010639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255900344
BLUE CROSS BLUE SHIELD
MI
05
—
3526975
—
MI
Enumeration date
10/03/2007
Last updated
10/24/2007
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