Healthcare Provider Details

I. General information

NPI: 1093642027
Provider Name (Legal Business Name): JOESEPH CONN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

IV. Provider business mailing address

1121 SHEFFIELD BLVD
LONDON OH
43140-2159
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax:
Mailing address:
  • Phone: 760-828-3161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: