| Doctor Name: | CONRADO ESCANO FERNANDEZ |
| NPI Number: | 1518057926 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 044716 |
| Business Practice Address: | 1 Medical Park Southern Medical Clinic Pc Valley, AL - 368543665 |
| Business Phone Number: | 3347562101 |
| Business Fax Number: | 3347565820 |
| Mailing Address: | 1 Medical Park, Southern Medical Clinic Pc VALLEY |
| State: | AL |
| Postal Code: | 368543665 |
| Phone Number: | 3347562101 |
| Fax Number: | 3347565820 |
| NPI Enumeration Date: | 10/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 044716 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |