Healthcare Provider Details

I. General information

NPI: 1194785063
Provider Name (Legal Business Name): AYRN D O'CONNOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 E WILLETTA ST FL 2
PHOENIX AZ
85006-2749
US

IV. Provider business mailing address

1441 N 12TH ST
PHOENIX AZ
85006-2837
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-2391
  • Fax:
Mailing address:
  • Phone: 602-495-4577
  • Fax: 602-417-3549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number33871
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33871
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: