Provider Demographics
NPI:1114545316
Name:CONNER, ANTHONY M (PHLEBOTOMY CERTIFICA)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:CONNER
Suffix:
Gender:M
Credentials:PHLEBOTOMY CERTIFICA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENERAL DELIVERY
Mailing Address - Street 2:
Mailing Address - City:KURTISTOWN
Mailing Address - State:HI
Mailing Address - Zip Code:96760-9999
Mailing Address - Country:US
Mailing Address - Phone:808-463-5317
Mailing Address - Fax:
Practice Address - Street 1:16-2005 HOPUE RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96771
Practice Address - Country:US
Practice Address - Phone:808-463-5317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZ5D5Q3Q6246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy