Provider Demographics
NPI:1043363781
Name:O'CONNOR, MICHAEL ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10530 N CAMINO ROSAS NUEVAS
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-7078
Mailing Address - Country:US
Mailing Address - Phone:520-797-7807
Mailing Address - Fax:520-544-8197
Practice Address - Street 1:7070 N ORACLE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4337
Practice Address - Country:US
Practice Address - Phone:520-742-8883
Practice Address - Fax:520-544-8197
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ23105001OtherSTATE COMP
AZAZ0237370OtherBCBS (NOT CONTRACTED)
AZ1Z1711OtherHEALTHNET
AZ350037074OtherRAILROAD MEDICARE
AZ2455199OtherAETNA
AZ656192OtherACN
AZ2455199OtherAETNA
AZZDC5001AMedicare ID - Type Unspecified