Organization
BRYAN R CONKLIN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN R CONKLIN MD PC (PRESIDENT)
(541) 963-4139
Entity
Organization
Contact information
Practice address
2011 FOURTH STREET, LA GRANDE, OR 97850-1200
(541) 963-4139
(541) 963-4412
Mailing address
2011 FOURTH STREET, LA GRANDE, OR 97850-1200
(541) 963-4139
(541) 963-4412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23049
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228792
—
OR
Enumeration date
01/23/2008
Last updated
04/19/2012
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