Provider Demographics
NPI:1760647556
Name:CONNER, JAMES RYAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RYAN
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 S. JACKSON HWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660
Mailing Address - Country:US
Mailing Address - Phone:256-386-1125
Mailing Address - Fax:888-745-7084
Practice Address - Street 1:1120 S JACKSON HWY STE 105
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5770
Practice Address - Country:US
Practice Address - Phone:256-386-1125
Practice Address - Fax:888-745-7084
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29791208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
630962367OtherIRS