Conley, John Ellis

Conley, John Ellis is an individual health care provider with primary practice located at 2152 Gold Dust Ct , Trinity FL 34655-5015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Conley, John Ellis can be contacted via phone (727) 375-8619.

Contact Information

Primary practice address
2152 Gold Dust Ct Trinity FL 34655-5015
Phone: (727) 375-8619
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 23641 Arizona
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 55683 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD6535 Hawaii
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0101241572 Virginia

Profile Details

NPI number 1063537249
LBN Legal business name Conley, John Ellis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Nov 2nd, 2009 - about 15 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 1063537249 NPPES
Florida Other 11388A FL MEDICARE B PROVIDER NUMBER
Florida MEDICAID 270964300 FL MEDICARE B PROVIDER NUMBER

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