Provider Demographics
NPI:1225357668
Name:CONNER, BRAD J (DO)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:J
Last Name:CONNER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:120 N 7TH ST STE 101
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1795
Practice Address - Country:US
Practice Address - Phone:717-263-1220
Practice Address - Fax:717-263-6255
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2021-09-10
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Provider Licenses
StateLicense IDTaxonomies
MI5101018654207X00000X
KY03879207XX0005X
OH34.011686207XX0005X
PAOS018267207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103132679Medicaid
MI5101018654OtherDEPARTMENT OF COMMUNITY HEALTH
MI5315045086OtherDEPARTMENT OF COMMUNITY HEALTH