Organization
LISA B CONNERY MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAVA BRADLEY (OFFICE MANAGER)
(405) 701-4079
Entity
Organization
Contact information
Practice address
1125 N PORTER AVE, SUITE 205, NORMAN, OK 73071-6446
(405) 701-4079
(405) 701-2838
Mailing address
1125 N PORTER AVE, SUITE 205, NORMAN, OK 73071-6446
(405) 701-4079
(405) 701-2838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16929
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4206638
AETNA
OK
01
—
444742697002
BCBS
OK
Enumeration date
11/13/2006
Last updated
08/22/2020
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