Basic Information
| Provider Information | |||||||||
| NPI: | 1851569578 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OCONNOR | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37000 N GANTZEL RD | ||||||||
| Address2: | |||||||||
| City: | SAN TAN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851407303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805432034 | ||||||||
| FaxNumber: | 4805432647 | ||||||||
| Practice Location | |||||||||
| Address1: | 37000 N GANTZEL RD | ||||||||
| Address2: | |||||||||
| City: | SAN TAN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851407303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805432034 | ||||||||
| FaxNumber: | 4805432647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2008 | ||||||||
| LastUpdateDate: | 12/27/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 15562 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.