Individual
DR. CLINT G CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
17 DEER RUN, HERRIN, IL 62948-2468
(618) 889-0590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036108965
IL
208M00000X
Hospitalist Physician
Primary
036108965
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108965
—
IL
01
—
084974
HEALTH ALLIANCE
—
01
—
3932056
BCBS
IL
01
—
555252
HEALTHLINK
—
01
—
721089
AETNA
IL
Enumeration date
01/23/2006
Last updated
05/13/2022
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