| Robert J Mcconnell | |
|
107 Kenbrook Dr Vandalia OH 45377-2427 | |
| (937) 890-6252 | |
| (937) 890-1725 |
| Full Name | Robert J Mcconnell |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 107 Kenbrook Dr, Vandalia, Ohio |
| Authorized Official Name and Position | Robert J Mcconnell (OWNER) |
| Authorized Official Contact | 9378906252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert J Mcconnell P.o. Box 235 Vandalia OH 45377-2427 Ph: (937) 890-6252 | Robert J Mcconnell 107 Kenbrook Dr Vandalia OH 45377-2427 Ph: (937) 890-6252 |
| NPI Number | 1750570164 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 11/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750570164 | NPI | - | NPPES |
| 0877761 | Medicaid | OH | |
| DP5373 | Other | OH | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 1569 (Ohio) | Primary |
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