Individual
JASON CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
11087 MAIN ST, MARTIN, KY 41649-7999
(606) 285-0681
(606) 285-6619
Mailing address
PO BOX 910, MARTIN, KY 41649-0910
(606) 285-0681
(606) 285-6619
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA677
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95002614
—
KY
Enumeration date
04/11/2006
Last updated
07/08/2007
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