Provider Demographics
NPI:1467670463
Name:O'CONNOR, THOMAS E (MA,CCC-A)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S ZEEB RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8326
Mailing Address - Country:US
Mailing Address - Phone:734-994-8300
Mailing Address - Fax:734-994-8353
Practice Address - Street 1:203 S ZEEB RD
Practice Address - Street 2:SUITE 207
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8326
Practice Address - Country:US
Practice Address - Phone:734-994-8300
Practice Address - Fax:734-994-8353
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000183231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP46900001Medicare PIN