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Individual

DOUGLAS ALLEN CONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
413 S LOOP RD, ST ELIZABETH FAMILY PRACTICE CENTER, EDGEWOOD, KY 41017-5446
(859) 301-3800
(859) 301-3987
Mailing address
413 S LOOP RD, ST ELIZABETH FAMILY PRACTICE CENTER, EDGEWOOD, KY 41017-5446
(859) 301-3800
(859) 301-3987

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01067451A
IN
207Q00000X
Family Medicine Physician
Primary
28181
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200407600
IN
05
2213661
OH
05
7100439330
KY
Enumeration date
03/23/2006
Last updated
03/08/2017
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