Individual
DR. JACOB EZRA CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
885 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1098
(419) 731-4282
(419) 731-4163
Mailing address
885 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1031
(419) 294-4991
(419) 209-0278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35091628
OH
207R00000X
Internal Medicine Physician
C2450
KY
207R00000X
Internal Medicine Physician
MD-53141
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2916778
—
OH
Enumeration date
02/04/2008
Last updated
12/02/2025
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