Scott Gerard Conklin
General Practice Physician
619 E Judge Perez Dr
Chalmette
, Louisiana 70043-5260
Scott Gerard Conklin
General Practice Physician
619 E Judge Perez Dr
Chalmette
, Louisiana 70043-5260
(504) 415-4959
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Scott Gerard Conklin
- 227 Angela St
- Arabi, LA
- Zip : 70032-1003
- Phone : (504) 415-4959
Second Address
- Scott Gerard Conklin
- 619 E Judge Perez Dr
- Chalmette, LA
- Zip : 70043-5260
- Fax : (504) 309-8954
- Phone : (504) 309-8837
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Is Scott Gerard Conklin a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | 022229 | LA |
National Provider Identifier
| NPI | 1043385693 |
|---|---|
| Provider Name | Scott Gerard Conklin |
| First Address | Arabi, LA 70032-1003 |
| Second Address | Chalmette, LA 70043-5260 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/11/2006 |
| Last Update Date | 17/12/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5BC18 | MEDICARE GROUP (01) | LA |
| GO7810 | (02) | LA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.