Individual
KENNETH ANDREW CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
881 USS JAMES MADISON RD, NAVAL BRANCH HEALTH CLINIC, KINGS BAY, GA 31547-2531
(912) 573-8801
Mailing address
877 ARTHUR MOORE DR, GREEN COVE SPRINGS, FL 32043-9510
(904) 282-2385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01029429A
IN
207Q00000X
Family Medicine Physician
Primary
ME 72302
FL
Other
Enumeration date
10/02/2005
Last updated
03/18/2010
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