Provider Demographics
NPI:1154386712
Name:CONNERS, MICHAEL STANLEY III (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STANLEY
Last Name:CONNERS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:CONNERS
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4444 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2644
Mailing Address - Country:US
Mailing Address - Phone:225-293-3430
Mailing Address - Fax:225-293-3459
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1008
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-0416
Practice Address - Fax:225-769-9212
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS225612086S0129X
LA14097R2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06925021Medicaid
LA1045063Medicaid
LA4F179Medicare ID - Type UnspecifiedLA MEDICARE NUMBER
LA1045063Medicaid