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Individual

JERROD A. CONKLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3223 N WEBB RD, SUITE 1, WICHITA, KS 67226-8175
(316) 609-2600
(316) 609-2800
Mailing address
3223 N WEBB RD, SUITE 1, WICHITA, KS 67226-8175
(316) 609-2600
(316) 609-2800

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
15-01039
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2003475208B
KS
Enumeration date
07/08/2006
Last updated
01/21/2015
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