Provider Demographics
NPI:1851551261
Name:CONNELL, DAVID ROY (RCP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROY
Last Name:CONNELL
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 DOBBS DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31705-4165
Mailing Address - Country:US
Mailing Address - Phone:229-432-2626
Mailing Address - Fax:
Practice Address - Street 1:32 DOBBS DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-4165
Practice Address - Country:US
Practice Address - Phone:229-432-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007133227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified