Individual
SCOTT GERARD CONKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 E JUDGE PEREZ DR, CHALMETTE, LA 70043-5260
(504) 309-8837
(504) 309-8954
Mailing address
227 ANGELA ST, ARABI, LA 70032-1003
(504) 415-4959
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
022229
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5BC18
MEDICARE GROUP
LA
Enumeration date
11/21/2006
Last updated
12/17/2007
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