Organization
LAURENCE CONNELLEY
Active
Other names
West Little Rock Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE KENNETH CONNELLEY JR. D.P.M. (SOLE PROPRIETOR)
(501) 221-2266
Entity
Organization
Contact information
Practice address
10020 W MARKHAM ST, LITTLE ROCK, AR 72205-2130
(501) 221-2266
(501) 224-5660
Mailing address
10020 W MARKHAM ST, LITTLE ROCK, AR 72205-2130
(501) 221-2266
(501) 224-5660
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
59
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104333717
—
AR
05
—
128479748
—
AR
01
—
480015481
RAILROAD MEDICARE
AR
Enumeration date
05/09/2007
Last updated
06/24/2008
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