NPI Code Detail JSON Logo

1700114550 NPI number — EDWARD JOHN CONLEY D.O.

NPI Number: 1700114550
Health Care Provider/Practitioner: EDWARD JOHN CONLEY D.O.

Information about “1700114550” NPI (EDWARD JOHN CONLEY D.O.) exists in 1700114550 in HTML format HTML  |  1700114550 in plain Text format TXT  |  1700114550 in PDF (Portable Document Format) PDF  |  1700114550 in an XML format XML  formats.

NPI Number : 1700114550 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700114550",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CONLEY",
    "FirstName": "EDWARD",
    "MiddleName": "JOHN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "G3494 BEECHER RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLINT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48532-2735",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "810-230-8677",
    "MailingAddressFaxNumber": "810-230-7855",
    "FirstLinePracticeLocationAddress": "G3494 BEECHER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLINT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48532-2735",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "810-230-8677",
    "PracticeLocationAddressFaxNumber": "810-230-7855",
    "EnumerationDate": "12/04/2009",
    "LastUpdateDate": "12/04/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207QA0505X",
        "TaxonomyName": "Adult Medicine Physician",
        "LicenseNumber": "EC008064",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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