Provider Demographics
NPI:1609851971
Name:CONNER, STEPHEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W LITTLETON BLVD
Mailing Address - Street 2:SUTIE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2368
Mailing Address - Country:US
Mailing Address - Phone:303-730-1313
Mailing Address - Fax:
Practice Address - Street 1:609 W LITTLETON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2368
Practice Address - Country:US
Practice Address - Phone:303-730-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01224104Medicaid
CO01224104Medicaid
COCO305349Medicare PIN
COE21618Medicare UPIN
CO486038Medicare ID - Type Unspecified