Provider Demographics
NPI:1003054800
Name:CONNER, AUSTIN PAUL SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:PAUL
Last Name:CONNER
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:AUSTIN
Other - Middle Name:PAUL
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:599 MEHARG RD
Mailing Address - Street 2:
Mailing Address - City:MOLINO
Mailing Address - State:FL
Mailing Address - Zip Code:32577-5571
Mailing Address - Country:US
Mailing Address - Phone:850-587-2680
Mailing Address - Fax:850-479-0806
Practice Address - Street 1:6000 W HWY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512
Practice Address - Country:US
Practice Address - Phone:850-587-2680
Practice Address - Fax:850-479-0806
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL131561835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist