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Individual

DR. JAMES MICHAEL CONERLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3311 PRESCOTT RD, SUITE 201, ALEXANDRIA, LA 71301-3900
(318) 442-6767
(318) 441-1359
Mailing address
3311 PRESCOTT RD, SUITE 201, ALEXANDRIA, LA 71301-3900
(318) 442-6767
(318) 441-1359

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
08316R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020054415
ALL
01
1903167
BLUE CROSS
05
1903167
LA
01
331030935A004
TRICARE
01
331030935CO
OCHSNER
01
5N052CD82
ALL
Enumeration date
07/19/2005
Last updated
09/29/2011
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