Individual
KEVIN P CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1602 SKIPWITH RD, RICHMOND, VA 23229-5205
(804) 200-7575
(804) 200-7069
Mailing address
8316 CHARING LN, GLEN ALLEN, VA 23059-5389
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102037028
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006706029
—
VA
05
—
006706100
—
VA
05
—
010210941
—
VA
05
—
010376963
—
VA
Enumeration date
07/28/2005
Last updated
02/13/2017
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