Provider Demographics
NPI:1144213992
Name:OCONNOR, THOMAS M (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-733-4644
Mailing Address - Fax:717-733-7865
Practice Address - Street 1:804 GRANDVIEW DR STE 2
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522
Practice Address - Country:US
Practice Address - Phone:717-466-2500
Practice Address - Fax:717-733-7865
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009572L208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
963231OtherBLUE SHIELD OF PA
PA001602890Medicaid
PA20020201OtherMERCY HEALTH PLAN
PA50009563OtherCAPITAL BLUE CROSS
P00000115OtherRAILROAD MEDICARE
PA20020201OtherMERCY HEALTH PLAN
PA001602890Medicaid
F88101Medicare UPIN
PAF88101Medicare UPIN