Provider Demographics
NPI:1609812122
Name:CONNER, MARSENA E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSENA
Middle Name:E
Last Name:CONNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1159 E 200 N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2022
Mailing Address - Country:US
Mailing Address - Phone:801-756-5609
Mailing Address - Fax:801-756-5200
Practice Address - Street 1:1159 E 200 N
Practice Address - Street 2:SUITE 200
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2022
Practice Address - Country:US
Practice Address - Phone:801-756-5609
Practice Address - Fax:801-756-5200
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT363993-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics