Individual
PHILLIP STEPHEN CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1960 TYBEE ST, LAKE CHARLES, LA 70605-4173
(337) 421-0090
(337) 421-0015
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
024152
LA
207Q00000X
Family Medicine Physician
Primary
MD.024152
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1571229
—
LA
Enumeration date
04/19/2006
Last updated
09/17/2016
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