Individual
DR. JAY ROSS CONNELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 JORDAN DR, MONTICELLO, AR 71655-5719
(870) 723-4921
Mailing address
PO BOX 417, MONTICELLO, AR 71657-0417
(870) 460-9001
(870) 412-4575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C8242
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128888001
—
AR
01
—
178800000
QUALCHOICE
AR
01
—
77007401
BREASTCARE
AR
01
—
80133356
TRAVERLERS RAILROAD
AR
Enumeration date
01/17/2006
Last updated
04/03/2024
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