Physician Compare National (NPI:1245531821)

HEALTHCARE PROVIDER: EBONY B CONNER D.P.M

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1245531821
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406070101
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140619002498
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CONNER
	Individual professional last name
Provider First Name	EBONY
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	212 GA HWY 49 N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 900
	Group Practice or individual's line 2 address
City	BYRON
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	310084064
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y