Individual
CONNOR JEFFERY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT017804
PA
208M00000X
Hospitalist Physician
Primary
2020021391
MO
Other
Enumeration date
07/20/2017
Last updated
12/10/2020
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