Provider Demographics
NPI:1568462158
Name:CONLAN, BARRY OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:OWEN
Last Name:CONLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3020 N MCCORD RD
Mailing Address - Street 2:200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1702
Mailing Address - Country:US
Mailing Address - Phone:419-843-3349
Mailing Address - Fax:419-841-2349
Practice Address - Street 1:3020 N MCCORD RD
Practice Address - Street 2:200
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1702
Practice Address - Country:US
Practice Address - Phone:419-843-3349
Practice Address - Fax:419-841-2349
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-058646207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0783899Medicaid
OHE70509Medicare UPIN
OHCO0669486Medicare ID - Type Unspecified