Provider Demographics
NPI:1679542997
Name:CONROY, JANE KIRKER (DO)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KIRKER
Last Name:CONROY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 POPLAR CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2314
Mailing Address - Country:US
Mailing Address - Phone:717-695-9177
Mailing Address - Fax:
Practice Address - Street 1:797 POPLAR CHURCH RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2314
Practice Address - Country:US
Practice Address - Phone:717-695-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004743L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01103401OtherCAPITAL BLUE CROSS
GA080118601OtherPALMETTO BGA - RAILROAD
PA420084OtherHIGHMARK BLUE SHIELD
PAC33782Medicare UPIN
PA420084Medicare ID - Type Unspecified