Individual ProviderConner MarsdenInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638(210) 292-7805PECOS EnrollmentBased on the most recent information from CMS, provider Conner Marsden is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1851974307Provider TypeIndividualFull NameMarsden, ConnerCredentialDOGenderMaleSole ProprietorYesEnumeration Date5/3/2021Last Updated9/11/2024Contact InformationPractice LocationPractice Address1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638Phone(210) 292-7805FaxUnlisted FaxMailing LocationMailing Address1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense02007923AIndianaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseR3568Arizona