Individual
TIMOTHY JOHN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 566-4520
Mailing address
5125 SKYLINE ROAD S, SALEM, OR 97306-9427
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OR MD22748
OR
208VP0000X
Pain Medicine Physician
OR MD22748
OR
Other
Enumeration date
08/31/2006
Last updated
07/12/2007
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