Provider Demographics
NPI:1881993475
Name:O'CONNELL, KRISTOPHER L (DO)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:L
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-5035
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:7 MAIN RD N
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1334
Practice Address - Country:US
Practice Address - Phone:207-862-9400
Practice Address - Fax:207-862-9411
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2014-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEDO2411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine