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General NPI Number Information
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NPI Number | 1164910303
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Entity Type | Individual
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Provider Name | JOSEPH HOWARD CONDUFF III MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 830 DAVIS ST
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City | BLACKSBURG
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State | VA
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Zip | 24060-7010
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Country | US
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Telephone | 540-392-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 STANLEY RD
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-5933
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Country | US
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Telephone | 540-392-0774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101278911
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License Number State | VA
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