Provider Demographics
NPI:1831225523
Name:CONNELL, SHERMAN LEN (DC)
Entity type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:LEN
Last Name:CONNELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HUGHES RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1144
Mailing Address - Country:US
Mailing Address - Phone:256-325-1222
Mailing Address - Fax:256-325-1222
Practice Address - Street 1:401 HUGHES RD STE 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-325-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51170190OtherBLUE CROSS BLUE SHEILD
TN1667544OtherCIGNA
TN4474714OtherAETNA
TN3676103Medicare ID - Type Unspecified
TN1667544OtherCIGNA