Conkling, Paul R
Conkling, Paul R is an individual health care provider with primary practice located at 5900 Lake Wright Dr , Norfolk VA 23502-1871. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Conkling, Paul R can be contacted via phone (757) 466-8683.Contact Information
Primary practice address
5900 Lake Wright Dr
Norfolk VA 23502-1871
Phone: (757) 466-8683
Fax: (757) 466-8892
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0101043323 | Virginia |
Profile Details
| NPI number | 1063417806 |
|---|---|
| LBN Legal business name | Conkling, Paul R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Apr 11th, 2011 - 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 | 1063417806 | NPPES |
| Virginia | MEDICAID | 006099131 | |
| Virginia | Other | 830003777 | |
| Virginia | Other | 15064 |
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