Provider Demographics
NPI:1447363700
Name:CONNER, ROBERT D (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:CONNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1501 50TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5920
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:888-503-7693
Practice Address - Street 1:13435 UNIVERSITY AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8249
Practice Address - Country:US
Practice Address - Phone:515-255-7132
Practice Address - Fax:515-218-1500
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA01911207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1447363700OtherBCBS
IA1208801Medicaid
IAI3203Medicare PIN