Basic Information
| Provider Information | |||||||||
| NPI: | 1073827556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'CONNELL | ||||||||
| FirstName: | MEGHAN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ELK POINT | ||||||||
| State: | SD | ||||||||
| PostalCode: | 570252334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053563317 | ||||||||
| FaxNumber: | 8664236811 | ||||||||
| Practice Location | |||||||||
| Address1: | 204 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ELK POINT | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053563317 | ||||||||
| FaxNumber: | 8664236811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2010 | ||||||||
| LastUpdateDate: | 10/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 107246 | MN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 10884 | SD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.