Healthcare Provider Details

I. General information

NPI: 1750385357
Provider Name (Legal Business Name): TIMOTHY A. CONNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17310 WRIGHT ST STE 103
OMAHA NE
68130-2405
US

IV. Provider business mailing address

1010 N 102ND ST STE 201
OMAHA NE
68114-2122
US

V. Phone/Fax

Practice location:
  • Phone: 833-228-6889
  • Fax: 877-853-0376
Mailing address:
  • Phone: 833-228-6889
  • Fax: 877-853-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberV6434
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2018035939
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number15891
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMTL-2023-028
License Number StateGU
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number15495
License Number StateND
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMC-198
License Number StateGU
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME139826
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number11756C
License Number StateWY
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG194370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: