Provider Demographics
NPI:1649252263
Name:CONNORS, JOHN PHILIP III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PHILIP
Last Name:CONNORS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:755 MOUNT VERNON HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4274
Mailing Address - Country:US
Mailing Address - Phone:404-348-4456
Mailing Address - Fax:404-348-4495
Practice Address - Street 1:755 MOUNT VERNON HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4274
Practice Address - Country:US
Practice Address - Phone:404-348-4456
Practice Address - Fax:404-348-4495
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2020-09-25
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Provider Licenses
StateLicense IDTaxonomies
GA060249208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
470374OtherTUFTS HEALTH PLAN
A38860OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
1074088OtherAETNA US HEALTHCARE
5645021OtherFIRST HEALTH
92688OtherFALLON COMMUNITY HEALTH
AA39058OtherHARVARD PILGRIM HEALTHCAR
J29061OtherBLUE CARE ELECT