Healthcare Provider Details

I. General information

NPI: 1851440887
Provider Name (Legal Business Name): STEVEN A CONROTTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N.MAIN STR. FAITH FAMILY PRACTICE
WEST LIBERTY KY
41472-1021
US

IV. Provider business mailing address

385 H HALE DR
EAST POINT KY
41216-8805
US

V. Phone/Fax

Practice location:
  • Phone: 606-743-1422
  • Fax: 606-743-3044
Mailing address:
  • Phone: 606-789-7492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28990
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: