Provider Demographics
NPI:1003060831
Name:CONLEY MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:CONLEY MEDICAL SERVICES, PLLC
Other - Org Name:CONLEY CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-745-1011
Mailing Address - Street 1:1323 N 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2134
Mailing Address - Country:US
Mailing Address - Phone:580-745-1011
Mailing Address - Fax:580-745-5332
Practice Address - Street 1:1323 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2134
Practice Address - Country:US
Practice Address - Phone:580-745-1011
Practice Address - Fax:580-745-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty