Conley, Justin T

Conley, Justin T is an individual health care provider with primary practice located at 610 30Th Ave W , Alexandria MN 56308-3426. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Conley, Justin T can be contacted via phone (320) 763-5123.

Contact Information

Primary practice address
610 30Th Ave W Alexandria MN 56308-3426
Phone: (320) 763-5123
Fax: (320) 763-7883
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 48867 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301111066 Michigan

Profile Details

NPI number 1033135298
LBN Legal business name Conley, Justin T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Oct 27th, 2016 - about 9 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 1033135298 NPPES
Minnesota Other 135595 UCARE #
Minnesota Other 623E1CO UCARE #
Minnesota Other 27253 UCARE #
Minnesota Other HP69889 UCARE #
Minnesota Other 0012-0006861 UCARE #
Minnesota MEDICAID 010437100 UCARE #
Minnesota Other 1033135298 UCARE #
Minnesota Other 1203709 UCARE #
Minnesota MEDICAID 13904 UCARE #

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