Conklin, Bryan Richard
Conklin, Bryan Richard is an individual health care provider with primary practice located at 2011 Fourth Street , La Grande OR 97850-1200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Conklin, Bryan Richard can be contacted via phone (541) 963-4139.Contact Information
Primary practice address
2011 Fourth Street
La Grande OR 97850-1200
Phone: (541) 963-4139
Fax: (541) 963-4412
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD23049 | Oregon |
Profile Details
| NPI number | 1346334075 |
|---|---|
| LBN Legal business name | Conklin, Bryan Richard |
| Credentials | MD PC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Apr 19th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346334075 | NPPES |
| Oregon | MEDICAID | 228792 |
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