Individual
DON R CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 LAKE TOMACHEECHEE DR, RINCON, GA 31326-5117
(912) 826-7310
(912) 826-7310
Mailing address
112 LAKE TOMACHEECHEE DR, RINCON, GA 31326-5117
(912) 826-7310
(912) 826-7310
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
020680
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00232889H
—
GA
01
—
GRP 2523
MEDICARE PROVIDER NUMBER
GA
Enumeration date
06/01/2005
Last updated
09/18/2013
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