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Contact Information

EDGAR M CONRAD IV, DO
2727 E. 32ND ST
STE 1
JOPLIN, MO64804
 Phone: 417-782-3292
 Fax: 417-782-4024
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for EDGAR M CONRAD IV · (Male)

NPI # 1124055074
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/27/2006
Last updated 08/10/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 107748
  • KS Medicaid 100235930C
  • MO Medicaid 248016636
  • OK Medicaid 100196580A
  • Other 110203265 RR MEDICARE
  • MO Other 3774 ANTHEM
Hospital affiliation(s)
  • FREEMAN HEALTH SYSTEM - FREEMAN WEST - (Acute Care)
    1102 WEST 32ND STREET
    JOPLIN, MO 64804
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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