Conkling, Jerrod A.

Conkling, Jerrod A. is an individual health care provider with primary practice located at 3223 N Webb Rd Suite 1, Wichita KS 67226-8175. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Conkling, Jerrod A. can be contacted via phone (316) 609-2600.

Contact Information

Primary practice address
3223 N Webb Rd Suite 1 Wichita KS 67226-8175
Fax: (316) 609-2800
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 15-01039 Kansas

Profile Details

NPI number 1114950706
LBN Legal business name Conkling, Jerrod A.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Jan 21st, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114950706 NPPES
Kansas MEDICAID 2003475208B

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