Provider Demographics
NPI:1144307265
Name:BRIAN E CONNER MD CHARTERED
Entity type:Organization
Organization Name:BRIAN E CONNER MD CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-825-2020
Mailing Address - Street 1:1518 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3236
Mailing Address - Country:US
Mailing Address - Phone:785-825-2020
Mailing Address - Fax:785-823-8151
Practice Address - Street 1:1518 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3236
Practice Address - Country:US
Practice Address - Phone:785-825-2020
Practice Address - Fax:785-823-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS015338207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS614810Other1ST GUARD
B68238Medicare UPIN
KS000346Medicare ID - Type Unspecified