| Doctor Name: | DR. MATTHEW JAMES CONNOLLY |
| NPI Number: | 1023010279 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 00180 |
| Business Practice Address: | 560 S Loop Rd Edgewood, KY - 410173405 |
| Business Phone Number: | 8593012663 |
| Business Fax Number: | 8593010655 |
| Mailing Address: | 560 S Loop Rd, EDGEWOOD |
| State: | KY |
| Postal Code: | 410173405 |
| Phone Number: | 8593012663 |
| Fax Number: | 8593010655 |
| NPI Enumeration Date: | 06/01/2005 |
| NPI Last Update Date: | 05/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 00180 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |