Provider Demographics
NPI:1477606879
Name:G. REID CONLEY, D.P.M., P.A.
Entity Type:Organization
Organization Name:G. REID CONLEY, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-234-3907
Mailing Address - Street 1:5311 LIMESTONE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1222
Mailing Address - Country:US
Mailing Address - Phone:302-234-3907
Mailing Address - Fax:302-234-3927
Practice Address - Street 1:5311 LIMESTONE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1246
Practice Address - Country:US
Practice Address - Phone:302-234-3907
Practice Address - Fax:302-234-3927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000089213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0402788000OtherAMERIHEALTH
DE1699OtherCOVENTRY HEALTH CARE
DE0000196317Medicaid
DET343OtherCARE FIRST
DE4370221OtherAETNA
DE7151578003OtherCIGNA
DE0000196317Medicaid
DE0000196317Medicaid
DEC0581139Medicare PIN
DE7151578003OtherCIGNA