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General NPI Number Information
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NPI Number | 1649252263
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Entity Type | Individual
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Provider Name | JOHN PHILIP CONNORS III MD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY SUITE 250
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City | ATLANTA
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 404-348-4456
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Fax | 404-348-4495
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Provider Business Mailing Address
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Address Line | 755 MOUNT VERNON HWY SUITE 250
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City | ATLANTA
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 404-348-4456
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Fax | 404-348-4495
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 060249
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License Number State | GA
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