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General NPI Number Information
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NPI Number | 1245232800
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Entity Type | Individual
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Provider Name | MARK O'CONNOR MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 02/06/2009
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Provider Practice Location Address
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Address Line | 2409 CHERRY ST STE 100
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City | TOLEDO
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State | OH
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Zip | 43608-2625
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Country | US
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Telephone | 419-251-3700
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Fax | 419-251-3835
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Provider Business Mailing Address
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Address Line | 2409 CHERRY ST STE 100
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City | TOLEDO
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State | OH
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Zip | 43608-2625
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Country | US
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Telephone | 419-251-3700
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Fax | 419-251-3835
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 350721050
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License Number State | OH
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