Provider Demographics
NPI:1114924578
Name:CONNOR, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:CONNOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2330 E MEYER BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1132
Mailing Address - Country:US
Mailing Address - Phone:816-333-5424
Mailing Address - Fax:816-822-0870
Practice Address - Street 1:2330 E MEYER BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1132
Practice Address - Country:US
Practice Address - Phone:816-333-5424
Practice Address - Fax:816-822-0870
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2003005215207RG0100X
KS04-27001207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100642590AMedicaid
MO206074601Medicaid
P00045637OtherRR MEDICARE
KS100642590AMedicaid
P00045637OtherRR MEDICARE