Basic Information
| Provider Information | |||||||||
| NPI: | 1629049457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCONNOR | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | KARL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18511 N SCOTTSDALE RD | ||||||||
| Address2: | STE 202 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803067242 | ||||||||
| FaxNumber: | 4803066246 | ||||||||
| Practice Location | |||||||||
| Address1: | 18511 N SCOTTSDALE RD | ||||||||
| Address2: | STE 202 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803067242 | ||||||||
| FaxNumber: | 4803066246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 33962 | AZ | N | Allopathic & Osteopathic Physicians | Anesthesiology | 208VP0014X | 33962 | AZ | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 967713 | 05 | AZ | MEDICAID | P00353896 | 01 | MEDICARE RAILROAD | OTHER |