Provider Demographics
NPI:1568553683
Name:OCONNOR, MARTIN THOMAS JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:THOMAS
Last Name:OCONNOR
Suffix:JR
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-873-9533
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:3100 SPRING FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2880
Practice Address - Country:US
Practice Address - Phone:919-873-9533
Practice Address - Fax:919-873-9821
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2015-10-27
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Provider Licenses
StateLicense IDTaxonomies
VA0024156386367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered