Healthcare Provider Details

I. General information

NPI: 1114924578
Provider Name (Legal Business Name): MICHAEL J CONNOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 E MEYER BLVD SUITE 301
KANSAS CITY MO
64132-1132
US

IV. Provider business mailing address

2330 E MEYER BLVD SUITE 301
KANSAS CITY MO
64132-1132
US

V. Phone/Fax

Practice location:
  • Phone: 913-234-7600
  • Fax: 816-361-5775
Mailing address:
  • Phone: 913-234-7600
  • Fax: 816-361-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number04-27001
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2003005215
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: