Individual
DR. NICHOLAS CHARLES CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 382-4321
(801) 676-5961
Mailing address
PO BOX 3330, SALT LAKE CITY, UT 84110-3330
(888) 333-1095
(801) 676-5961
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
24015
NE
207L00000X
Anesthesiology Physician
C134444
CA
207L00000X
Anesthesiology Physician
Primary
MD176096
OR
Other
Enumeration date
01/26/2007
Last updated
04/06/2016
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