Provider Demographics
NPI:1700189412
Name:GEOFFREY CONNOR MD PC
Entity Type:Organization
Organization Name:GEOFFREY CONNOR MD PC
Other - Org Name:D1 SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-803-3700
Mailing Address - Street 1:1651 INDEPENDENCE CT
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4153
Mailing Address - Country:US
Mailing Address - Phone:205-803-3700
Mailing Address - Fax:205-803-3707
Practice Address - Street 1:1651 INDEPENDENCE CT
Practice Address - Street 2:SUITE 211
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4153
Practice Address - Country:US
Practice Address - Phone:205-803-3700
Practice Address - Fax:205-803-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty