Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2008007439 | MO |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 40321 | TN |
N | 207YP0228X | Pediatric Otolaryngology | 2008007439 | MO |
N | 207YP0228X | Pediatric Otolaryngology | 40321 | TN |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 40321 | TN |
NPI | 1881875961 |
---|---|
Provider Name | Dr. John Matthew Conoyer |
First Address | St. Peters, MO 63376 |
Second Address | St. Peters, MO 63376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2007 |
Last Update Date | 04/06/2010 |