Individual provider · NPI-1

Dr. Carlos R Conesa, MD

General Practice · Muskogee, OK

NPI number1366914111
StatusActive
Last updated in NPPESApr 13, 2021

Details

NPI
1366914111
Entity type
Individual (NPI-1)
Name
Dr. Carlos R Conesa
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 18, 2018
Certification date
Apr 13, 2021
Last updated
Apr 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice21181PRYes
207R00000X Internal MedicineLP04752RI

Practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Phone 918-577-3000

Mailing address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone 401-456-2032 · Fax 401-456-6719

Other practice locations

Southern Medical Plaza
80 Calle 3 Sur
Guayama, PR 00784

Phone 787-866-1212 · Fax 787-866-3322

Southern Medical Plaza
80 Calle 3 Sur
Guayama, PR 00784

Phone 787-866-1212 · Fax 787-866-3322

825 Chalkstone Ave
Providence, RI 02908

Phone 401-456-2032 · Fax 401-456-6719

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