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Individual

JAMES VINCENT CONNELL JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3716
(319) 233-1630
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-3716
(319) 233-1630

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21127
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0482950
IA
01
08701
WELLMARK HEALTH
IA
01
421417307K8
JOHN DEERE HEALTH
IA
Enumeration date
06/12/2006
Last updated
07/08/2007
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