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Organization
LAURENCE CONNELLEY
Active
Organization
LAURENCE CONNELLEY
Active
Other names
West Little Rock Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE KENNETH CONNELLEY JR. D.P.M. (SOLE PROPRIETOR)
(501) 221-2266
Entity
Organization
Contact information
Practice address
10020 W MARKHAM ST, LITTLE ROCK, AR 72205-2130
(501) 221-2266
(501) 224-5660
Mailing address
10020 W MARKHAM ST, LITTLE ROCK, AR 72205-2130
(501) 221-2266
(501) 224-5660
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
59
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104333717
—
AR
05
—
128479748
—
AR
01
—
480015481
RAILROAD MEDICARE
AR
Enumeration date
05/09/2007
Last updated
06/24/2008
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