Provider Demographics
NPI:1386619807
Name:CONNER, JAMES RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RYAN
Last Name:CONNER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1118 ROSS CLARK CIR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3001
Mailing Address - Country:US
Mailing Address - Phone:334-794-3192
Mailing Address - Fax:334-792-7513
Practice Address - Street 1:1118 ROSS CLARK CIR
Practice Address - Street 2:SUITE 303
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3001
Practice Address - Country:US
Practice Address - Phone:334-794-3192
Practice Address - Fax:334-792-7513
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-19
Last Update Date:2009-12-16
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Provider Licenses
StateLicense IDTaxonomies
AL22776207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00825591AOtherGEORGIA MEDICAID
ALP00031526OtherRRMC
AL051512609OtherALABAMA BLUE CROSS
AL051552723Medicaid
FL61992OtherFLORIDA BLUE CROSS
AL051512609OtherALABAMA BLUE CROSS
FL61992OtherFLORIDA BLUE CROSS