Individual
JAMIE DAVID CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-7715
(541) 598-3492
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 706-7715
(541) 598-3492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6353674-1205
UT
207R00000X
Internal Medicine Physician
MD153265
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD153265
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD60807243
WA
207RP1001X
Pulmonary Disease Physician
Primary
01083135A
IN
207RP1001X
Pulmonary Disease Physician
MD153265
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500641194
—
OR
Enumeration date
10/09/2007
Last updated
11/10/2021
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