Individual
DR. SKY B CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5310 HOMESTEAD RD NE, SUITE 301, ALBUQUERQUE, NM 87110-1437
(505) 872-4700
(505) 872-4709
Mailing address
5310 HOMESTEAD RD NE, SUITE 301, ALBUQUERQUE, NM 87110-1437
(505) 872-4700
(505) 872-4709
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2000166
NM
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2000166
NM
207NS0135X
Procedural Dermatology Physician
2000166
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015106
MC RR
—
01
—
NM009032
BCBS
NM
Enumeration date
09/13/2005
Last updated
01/03/2011
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