Provider Demographics
NPI:1851355945
Name:CONELL, LAWRENCE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:CONELL
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:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-7007
Mailing Address - Fax:540-564-7038
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-7007
Practice Address - Fax:540-564-7038
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010331102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1000870001OtherDME PROVIDER
49119000OtherMAGELLAN
VA7110464Medicaid
178633OtherCOM PSYCH
18761OtherCIGNA BEHAVIORAL HEALTH
260039340OtherRAILROAD MEDICARE
O88283OtherSENTARA
012441OtherVALUE OPTIONS
WV7100050000OtherWV MEDICAID
VA88283OtherOPTIMA
264430OtherANTHEM/BCBS
18761OtherCIGNA BEHAVIORAL HEALTH
260002569Medicare ID - Type Unspecified
264430OtherANTHEM/BCBS