STEPHEN L CONERLY (NPI# 1174530448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174530448 |
| Entity Type | Individual |
| Full Name | STEPHEN L CONERLY |
| Credential | MD |
| Practice Address |
104 Asbury Cir Hattiesburg MS 39402-1302 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012685252 |
| Practice Fax Number | 6012685190 |
| Mailing Telephone | 6012685252 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 08717 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1385751 | 05 | |
| MS | 00115155 | 05 | |
| MS | AMIERICAN ADMIN GROUP | 1559128 | 01 |
| Street Address |
104 ASBURY CIR |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-1302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760896195 | Maureen Offiah | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2014-06-13 |
| 1851488118 | Hattiesburg Clinic Pa | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-10-06 |
| 1841306297 | William H Gullung IIi | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-08-21 |
| 1336159607 | Mark A Gallardo | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053592840 | William Lowe Waller IIi | Dermatology | 3 Thompson Park, Hattiesburg, MS 39401-8202 | 2007-11-20 |
| 1114014479 | Hattiesburg Clinic Pa | Dermatology | 6 Medical Blvd, Hattiesburg, MS 39401-7230 | 2006-10-06 |
| 1487769808 | Ronald R Lubritz | Dermatology | 205 Pinehills Dr, Hattiesburg, MS 39402-3319 | 2006-08-19 |
| 1427417724 | Hattiesburg Clinic, Pa | Dermatology | 3 Thompson Park, Hattiesburg, MS 39401-8202 | 2016-02-15 |
| 1760896195 | Maureen Offiah | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2014-06-13 |
| 1790926780 | Elizabeth Reagan Francis Rose | Dermatology | 3 Thompson Park, Hattiesburg, MS 39401-8202 | 2009-03-20 |
| 1346377769 | Rebecca Duff | Dermatology | 40 Franklin Rd, Hattiesburg, MS 39402-1318 | 2007-02-27 |
| 1851488118 | Hattiesburg Clinic Pa | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-10-06 |
| 1841306297 | William H Gullung IIi | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-08-21 |
| 1336159607 | Mark A Gallardo | Dermatology | 104 Asbury Cir, Hattiesburg, MS 39402-1302 | 2006-08-09 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.