Individual
KEITH CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE STE 190, MARQUETTE, MI 49855-5406
(906) 225-1321
(906) 228-9371
Mailing address
1414 W FAIR AVE STE 190, MARQUETTE, MI 49855-5406
(906) 225-1321
(906) 228-9371
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301117275
MI
207X00000X
Orthopaedic Surgery Physician
MT203824
PA
Other
Enumeration date
05/15/2013
Last updated
08/02/2019
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