Connolly, Jared
Connolly, Jared is an individual health care provider with primary practice located at 9000 W Sura Ln , Greenfield WI 53228. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Connolly, Jared can be contacted via phone (414) 246-6800.Contact Information
Primary practice address
9000 W Sura Ln
Greenfield WI 53228
Phone: (414) 246-6800
Fax: (414) 246-6405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 71078 | Wisconsin |
Profile Details
| NPI number | 1790130474 |
|---|---|
| LBN Legal business name | Connolly, Jared |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 29th, 2016 |
| Last updated | Jan 9th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790130474 | NPPES |
| Wisconsin | MEDICAID | 100089836 |
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