Provider Demographics
NPI:1770800740
Name:O'CONNOR, RACHEL MICHELLE (DPM)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MICHELLE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-5246
Mailing Address - Country:US
Mailing Address - Phone:928-226-7555
Mailing Address - Fax:928-226-0014
Practice Address - Street 1:202 E BIRCH AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5246
Practice Address - Country:US
Practice Address - Phone:928-226-7555
Practice Address - Fax:928-226-0014
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0760213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist