Healthcare Provider Details

I. General information

NPI: 1093248536
Provider Name (Legal Business Name): DANIEL JAMES O'CONNOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 1ST ST
MORRIS MN
56267-1408
US

IV. Provider business mailing address

400 E 1ST ST
MORRIS MN
56267-1408
US

V. Phone/Fax

Practice location:
  • Phone: 320-589-1313
  • Fax:
Mailing address:
  • Phone: 320-589-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number67088
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: