MEDICARE: GEORGE W CONNER, MD

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
1	208600000X	Surgery Physician	139892	NY

General Provider Information

NPI Number	:	1760436950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE W CONNER, MD

Provider Business Mailing Address
First Line	:	17 SHERMAN ST
Second Line	:
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-7080
Country	:	US
Telephone Number	:	716-484-0173
Fax Number	:	716-484-0177

Provider Business Practice Location Address
First Line	:	17 SHERMAN ST
Second Line	:
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-7080
Country	:	US
Telephone Number	:	716-484-0173
Fax Number	:	716-484-0177

Authorized Official
Title or Position	:	MD
Name	:	GEORGE W CONNER
Credential	:	MD
Telephone Number	:	716-484-0173

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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