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NPI Code Detail

MEDICARE: ELIZABETH J MCCONNELL MD

MEDICARE: ELIZABETH J MCCONNELL 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
1208C00000XColon & Rectal Surgery Physician28532AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952393761
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH J MCCONNELL MD
Provider Business Mailing Address
First Line : PO BOX 5458
Second Line :
City : BELFAST
State : ME
Zip : 04915-5400
Country : US
Telephone Number : 602-253-4271
Fax Number : 602-253-4273
Provider Business Practice Location Address
First Line : 6245 N 16TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-1706
Country : US
Telephone Number : 602-253-4271
Fax Number : 602-253-4273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 11/30/2011

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