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General NPI Number Information
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NPI Number | 1861836413
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Entity Type | Organization
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Legal Business Name | CARL CONNORS OBGYN LLC
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 4705 MONTGOMERY BLVD NE STE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1246
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Country | US
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Telephone | 505-727-3280
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Fax | 505-727-3282
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Provider Business Mailing Address
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Address Line | 4705 MONTGOMERY BLVD NE STE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1246
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Country | US
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Telephone | 505-727-3280
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Fax | 505-727-3282
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARL J CONNORS
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Credential | DO
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Telephone | 505-727-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A-913-90
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License Number State | NM
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