Individual
JOSHUA S CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
230 E DAY RD STE 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Mailing address
230 E DAY RD STE 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001633
VA
152W00000X
Optometrist
1679DT
KY
152W00000X
Optometrist
Primary
18003496A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18003496A
LICENSE
IN
05
—
200888800
—
IN
01
—
P00653119
RR MEDICARE
IN
Enumeration date
08/19/2006
Last updated
03/21/2013
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