Individual
MICHAEL J CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 7TH AVE S, LOWDER 316, BIRMINGHAM, AL 35233-1711
(205) 638-9146
(205) 638-9833
Mailing address
1600 7TH AVE S, LOWDER 316, BIRMINGHAM, AL 35233-1711
(205) 638-9146
(205) 638-9833
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17564
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000085351
BLUE CROSS
AL
05
—
000085351
—
AL
05
—
009932087
—
AL
05
—
009996775
—
AL
01
—
0123411
MISSISSIPPI MEDICAID
MS
01
—
051528498
BLUE CROSS
AL
01
—
051529348
BLUE CROSS
AL
01
—
110723997A
GEORGIA MEDICAID
AL
01
—
F64351
VIVA
AL
Enumeration date
06/13/2006
Last updated
08/16/2013
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