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Individual
KELLY L CONKLIN
Active
Individual
KELLY L CONKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34-00-7113
OH
208M00000X
Hospitalist Physician
Primary
34.007113
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2155868
—
OH
Enumeration date
11/28/2005
Last updated
03/16/2011
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