Robert J Mcconnell
Family Doctor - Geriatric Medicine
107 Kenbrook Dr
Vandalia
, Ohio 45377-2427
Robert J Mcconnell
Family Doctor - Geriatric Medicine
107 Kenbrook Dr
Vandalia
, Ohio 45377-2427
(937) 890-1725
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Robert J Mcconnell
- P.o. Box 235
- Vandalia, OH
- Zip : 45377-2427
- Fax : (937) 890-1725
- Phone : (937) 890-1725
Second Address
- Robert J Mcconnell
- 107 Kenbrook Dr
- Vandalia, OH
- Zip : 45377-2427
- Fax : (937) 890-1725
- Phone : (937) 890-1725
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | OH34001569 | OH |
National Provider Identifier
| NPI | 1053393934 |
|---|---|
| Provider Name | Robert J Mcconnell |
| First Address | Vandalia, OH 45377-2427 |
| Second Address | Vandalia, OH 45377-2427 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/11/2005 |
| Last Update Date | 01/11/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000003522 | BC/BS (01) | OH |
| 0020391 | (05) | OH |
| 010047653 | RAILROAD MEDICARE (01) | OH |
| A14298 | UPIN (01) | OH |
| AM2812875 | DEA (01) | OH |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.