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NPI Code Detail

MEDICARE: CHARLES L CONLEY II D.O.

MEDICARE: CHARLES L CONLEY II D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician34.007949OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386616373
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES L CONLEY II D.O.
Provider Business Mailing Address
First Line : PO BOX 1595
Second Line :
City : ASHLAND
State : KY
Zip : 41105-1595
Country : US
Telephone Number : 606-408-4000
Fax Number :
Provider Business Practice Location Address
First Line : 912 PARK AVE
Second Line :
City : IRONTON
State : OH
Zip : 45638-1596
Country : US
Telephone Number : 740-532-1100
Fax Number : 740-534-0029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 02/10/2022

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Directions to “ CHARLES L CONLEY II D.O.” Practice Location

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