Individual
DR. BRANDON KEITH CONNERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 E WHISKEY RUN RD NE, NEW SALISBURY, IN 47161-9345
(812) 347-9977
Mailing address
PO BOX 38, CORYDON, IN 47112-0038
(812) 738-4251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01058296A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000322352
BC/BS #
IN
05
—
200459910
—
IN
05
—
2475101
—
OH
Enumeration date
07/28/2005
Last updated
07/18/2022
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