Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 50333 | TN |
Y | 2080P0214X | Pediatric Pulmonologist | 50333 | TN |
NPI | 1578889580 |
---|---|
Provider Name | Michael Glenn O'connor |
First Address | Nashville, TN 37232-5100 |
Second Address | Nashville, TN 37232-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 15/10/2020 |