Provider Demographics
NPI:1568546646
Name:CONLY, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:CONLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:924 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:RENOVO
Mailing Address - State:PA
Mailing Address - Zip Code:17764-1191
Mailing Address - Country:US
Mailing Address - Phone:570-923-2700
Mailing Address - Fax:570-923-0824
Practice Address - Street 1:924 HURON AVE
Practice Address - Street 2:
Practice Address - City:RENOVO
Practice Address - State:PA
Practice Address - Zip Code:17764-1191
Practice Address - Country:US
Practice Address - Phone:570-923-2700
Practice Address - Fax:570-923-0824
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025258E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188455OtherBLUE SHIELD
PA1204-C2CGOtherGEISINGER HEALTH PLAN
PA080149939OtherRAILROAD MEDICARE
PA0009461700004Medicaid
PA002954OtherFIRST PRIORITY HEALTH
PA002954OtherFIRST PRIORITY HEALTH
PAC33107Medicare UPIN