Connerly, Brandon Keith

Connerly, Brandon Keith is an individual health care provider with primary practice located at 1601 E Whiskey Run Rd Ne , New Salisbury IN 47161-9345. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Connerly, Brandon Keith can be contacted via phone (812) 347-9977.

Contact Information

Primary practice address
1601 E Whiskey Run Rd Ne New Salisbury IN 47161-9345
Phone: (812) 347-9977
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01058296A Indiana

Profile Details

NPI number 1558361899
LBN Legal business name Connerly, Brandon Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jul 18th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558361899 NPPES
Indiana MEDICAID 200459910
Indiana MEDICAID 2475101
Indiana Other 000000322352

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