Provider Demographics
NPI:1245250919
Name:CONNOR, JAMES FRANCIS (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:CONNOR
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1851 OLD MOULTRIE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-4168
Mailing Address - Country:US
Mailing Address - Phone:904-824-8088
Mailing Address - Fax:904-826-4105
Practice Address - Street 1:1851 OLD MOULTRIE RD
Practice Address - Street 2:SUITE A
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4168
Practice Address - Country:US
Practice Address - Phone:904-824-8088
Practice Address - Fax:904-826-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2020-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4283452OtherAETNA
593076573OtherHUMANA
7080262005OtherCIGNA
593076573OtherUNITED HEALTHCARE
100699OtherAVMED
FL053888400Medicaid
FL80470OtherBLUE CROSS BLUE SHIELD
FL053888400Medicaid
4283452OtherAETNA