O'Connell, Ethan Tanner

O'Connell, Ethan Tanner is an individual health care provider with primary practice located at 1233 34Th St Nw , Bemidji MN 56601-5112. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. O'Connell, Ethan Tanner can be contacted via phone (218) 333-5596.

Contact Information

Primary practice address
1233 34Th St Nw Bemidji MN 56601-5112
Phone: (218) 333-5596
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X TL1362 Wyoming
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301092736 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 106348 Minnesota

Profile Details

NPI number 1306097928
LBN Legal business name O'Connell, Ethan Tanner
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2008
Last updated Sep 27th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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