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General NPI Number Information
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NPI Number | 1396743670
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Entity Type | Individual
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Provider Name | KEVIN A OCONNOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 05/05/2009
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Provider Practice Location Address
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Address Line | 6545 FRANCE AVE S #671
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City | EDINA
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State | MN
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Zip | 55435-2131
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Country | US
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Telephone | 952-829-1853
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Fax | 952-922-5047
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Provider Business Mailing Address
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Address Line | 6545 FRANCE AVE S #671
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City | EDINA
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State | MN
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Zip | 55435-2131
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Country | US
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Telephone | 952-829-1853
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Fax | 952-922-5047
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34055
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G48495
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24835
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License Number State | IA
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