Provider Demographics
NPI:1629178538
Name:CONNORS, CARL J (DO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:J
Last Name:CONNORS
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Gender:M
Credentials:DO
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Mailing Address - Street 1:6320 RIVERSIDE PLAZA LN NW STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1710
Mailing Address - Country:US
Mailing Address - Phone:505-843-6168
Mailing Address - Fax:505-792-1978
Practice Address - Street 1:4640 JEFFERSON LN NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2116
Practice Address - Country:US
Practice Address - Phone:505-843-6168
Practice Address - Fax:505-792-1978
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-07-15
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Provider Licenses
StateLicense IDTaxonomies
NMA-913-90207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM004926OtherBCBC OF NEW MEXICO
NMF8452Medicaid
NM98721011Medicaid
NMNM004926OtherHMO OF NEW MEXICO
NM201001970OtherPRESBYTERIAN HEALTH PLAN
NM10003733OtherLOVELACE SALUD
NM850464763OtherALL OTHER INSURANCE PLANS
NMPROVP11910OtherMOLINA SALUD
NMNM004926OtherHMO OF NEW MEXICO
NM368202YTYEMedicare PIN