Richard A Connell, DOM
Individual provider Active NPI Acupuncturist · El Prado, NM
NPI 1265620280 · NPPES record last updated Jun 17, 2008
Key facts
- NPI
- 1265620280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 931 (NM)
- Practice address
- 98 St Rd 150 Venado Plaza Ste 5
HC74 Box 24813
El Prado, NM 87529 - Phone
- (575) 776-8012
- NPI assigned
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 931 | NM | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 931 | NM | Yes |
Addresses
Primary practice location
98 St Rd 150 Venado Plaza Ste 5
HC74 Box 24813
El Prado, NM 87529
Mailing address
HC 74 Box 24813
El Prado, NM 87529-9533
Phone (575) 776-8012
Other providers in El Prado, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.