Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35-080-0340M | OH |
NPI | 1063426351 |
---|---|
Provider Name | Dr. Timothy B Mcconnell |
First Address | Cincinnati, OH 45247-7961 |
Second Address | Cincinnati, OH 45249-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 13/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2333068 | (05) | OH |
64-05308500 | (05) | KY |
H61641 | (02) | OH |
P00068010 | MEDICARE RAILROAD (01) | OH |