Conrad, Jeffrey Mark

Conrad, Jeffrey Mark is an individual health care provider with primary practice located at 6144 Airport Blvd , Mobile AL 36608-3143. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Conrad, Jeffrey Mark can be contacted via phone (251) 476-5050.

Contact Information

Primary practice address
6144 Airport Blvd Mobile AL 36608-3143
Phone: (251) 476-5050
Fax: (251) 450-2770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 00025851 Alabama

Profile Details

NPI number 1720046600
LBN Legal business name Conrad, Jeffrey Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated Jan 20th, 2010 - 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 1720046600 NPPES
Alabama Other 051522492 BCBS
Alabama Other 631187140 BCBS
Alabama MEDICAID 009960785 BCBS
Alabama Other P00143020 BCBS
Alabama MEDICAID 05723278 BCBS

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