Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | OS009572L | PA |
N | 208600000X | Surgeon | OS009572L | PA |
Y | 2086S0129X | Vascular Surgeon | OS009572L | PA |
NPI | 1144213992 |
---|---|
Provider Name | Thomas M Oconnor |
First Address | York, PA 17402-9001 |
Second Address | Ephrata, PA 17522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 20/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001602890 | (05) | PA |
20020201 | MERCY HEALTH PLAN (01) | PA |
50009563 | CAPITAL BLUE CROSS (01) | PA |
963231 | BLUE SHIELD OF PA (01) | |
F88101 | (02) | PA |
P00000115 | RAILROAD MEDICARE (01) |