Individual
DR. EDGAR M. CONRAD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2727 E. 32ND ST, STE 1, JOPLIN, MO 64804
(417) 782-3292
(417) 782-4024
Mailing address
2727 E. 32ND ST, STE 1, JOPLIN, MO 64804
(417) 782-3292
(417) 782-4024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
107748
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196580A
—
OK
05
—
100235930C
—
KS
01
—
110203265
RR MEDICARE
—
05
—
248016636
—
MO
01
—
3774
ANTHEM
MO
Enumeration date
06/27/2006
Last updated
08/10/2011
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