Provider Demographics
NPI:1225570294
Name:CONNELLY, FRANCIS
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:CONNELLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 15TH ST SW
Mailing Address - Street 2:SUITE #2
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5677
Mailing Address - Country:US
Mailing Address - Phone:641-450-0280
Mailing Address - Fax:641-450-0284
Practice Address - Street 1:1050 15TH ST SW
Practice Address - Street 2:SUITE #2
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5677
Practice Address - Country:US
Practice Address - Phone:641-450-0280
Practice Address - Fax:641-450-0284
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA81-1939780OtherNPI