Conerly, Stephen L

Conerly, Stephen L is an individual health care provider with primary practice located at 104 Asbury Cir , Hattiesburg MS 39402-1302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Conerly, Stephen L can be contacted via phone (601) 268-5252.

Contact Information

Primary practice address
104 Asbury Cir Hattiesburg MS 39402-1302
Fax: (601) 268-5190
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 08717 Mississippi

Profile Details

NPI number 1174530448
LBN Legal business name Conerly, Stephen L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 14th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174530448 NPPES
Mississippi MEDICAID 00115155
Mississippi MEDICAID 1385751
Mississippi Other 1559128

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