Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 5101018654 | MI |
Y | 207X00000X | Orthopaedic Surgeon | OS018267 | PA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 03879 | KY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 34.011686 | OH |
NPI | 1225357668 |
---|---|
Provider Name | Brad J Conner |
First Address | Chambersburg, PA 17201-4232 |
Second Address | Chambersburg, PA 17201-1795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2010 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103132679 | (05) | PA |
5101018654 | DEPARTMENT OF COMMUNITY HEALTH (01) | MI |
5315045086 | DEPARTMENT OF COMMUNITY HEALTH (01) | MI |