MEDICARE: DR. CAROLYN R O'CONNOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	MD046570L	PA

General Provider Information

NPI Number	:	1659310811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN R O'CONNOR MD

Provider Business Mailing Address
First Line	:	4300 ALLEN RD STE 210
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-1032
Country	:	US
Telephone Number	:	330-344-7820
Fax Number	:	330-928-4320

Provider Business Practice Location Address
First Line	:	1946 TOWN PARK BLVD STE 130
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8372
Country	:	US
Telephone Number	:	330-344-7820
Fax Number	:	330-928-4320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	04/02/2021

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