Connolly, Jared

Connolly, Jared is an individual health care provider with primary practice located at 9000 W Sura Ln , Greenfield WI 53228. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Connolly, Jared can be contacted via phone (414) 246-6800.

Contact Information

Primary practice address
9000 W Sura Ln Greenfield WI 53228
Phone: (414) 246-6800
Fax: (414) 246-6405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 71078 Wisconsin

Profile Details

NPI number 1790130474
LBN Legal business name Connolly, Jared
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2016
Last updated Jan 9th, 2024 - about 10 months 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 1790130474 NPPES
Wisconsin MEDICAID 100089836

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