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General NPI Number Information
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NPI Number | 1255309712
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Entity Type | Organization
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Legal Business Name | ELIZABETH J MCCONNELL MD PLC
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 6245 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-1706
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Country | US
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Telephone | 602-253-4271
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Fax | 602-253-4273
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Provider Business Mailing Address
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Address Line | 6245 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-1706
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Country | US
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Telephone | 602-253-4271
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Fax | 602-253-4273
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH J MCCONNELL
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Credential | MD
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Telephone | 602-253-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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