Provider Demographics
NPI:1124166970
Name:CONNOR, TONYA L (RPH)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:L
Last Name:CONNOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:L
Other - Last Name:SHELNUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1120 RIDGEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-1338
Mailing Address - Country:US
Mailing Address - Phone:706-310-9536
Mailing Address - Fax:706-310-9536
Practice Address - Street 1:3320 OLD JEFFERSON RD
Practice Address - Street 2:BLDG. 700A
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1400
Practice Address - Country:US
Practice Address - Phone:706-353-4344
Practice Address - Fax:706-353-4355
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH019263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist