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NPI Code Detail

MEDICARE: DAVID K CONNELL PH.D.

MEDICARE: DAVID K CONNELL PH.D.
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
1103T00000XPsychologist4675OH
2103TC0700XClinical Psychologist4675OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6P00322126OTHEROHRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2463779000OTHEROHMAGELLAN
3000000503824OTHEROHANTHEM BC
45692018OTHEROHAETNA
5291267OTHEROHTRICARE CHAMPUS

General Provider Information

NPI Number : 1750387577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID K CONNELL PH.D.
Provider Business Mailing Address
First Line : PO BOX 8440
Second Line :
City : TOLEDO
State : OH
Zip : 43623-0440
Country : US
Telephone Number : 419-788-7019
Fax Number :
Provider Business Practice Location Address
First Line : 1011 N BYRNE RD
Second Line :
City : TOLEDO
State : OH
Zip : 43607-2710
Country : US
Telephone Number : 419-788-7019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/19/2013

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