DR. JEFFREY ALLEN CONKLIN (NPI# 1598870719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598870719 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY ALLEN CONKLIN |
| Credential | M.D. |
| Practice Address |
850 W Baraga Ave Marquette MI 49855 |
| Mailing Address |
5700 Southwyck Blvd Toledo OH 43614-1509 |
| Practice Telephone | 9064493000 |
| Mailing Telephone | 8002888325 |
| Mailing Fax Number | 4198665453 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
036.120418 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PHYSICIAN LICENSE | 036.120418 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 303 E Chicago Ave, Department of Pathology, Ward 3-140, Chicago, IL 606114296 | 3125038223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265513238 | Jeffrey B Conklin | Internal Medicine | 21785 Filigree Ct, Suite 100, Ashburn, VA 20147-6213 | 2006-10-18 |
| 1265460372 | Jeffrey L Conklin | Specialist | 8700 Beverly Blvd., Los Angeles, CA 90048-1865 | 2006-06-29 |
| Street Address |
850 W BARAGA AVE |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417905258 | George Alan Krzymowski | Pathology | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2006-05-04 |
| 1255939500 | Ashley Barbara Veale | Physician Assistant | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-10-09 |
| 1992328942 | Miles Wenger | Registered Nurse | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-05-26 |
| 1700409141 | Megan Lynn Prange | Nurse Anesthetist, Certified Registered | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-05-20 |
| 1073148409 | Rachel Bonsall | Nurse Practitioner | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-03-05 |
| 1699306225 | Sarah Jean Bannan | Family Medicine | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-02-02 |
| 1386283067 | Joshua Rajala | Nurse Anesthetist, Certified Registered | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2019-12-30 |
| 1740824564 | Kelly Rose | Nurse Practitioner | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2019-11-05 |
| 1679115554 | Sara Marie Sauve | Registered Nurse | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2019-10-12 |
| 1336793280 | Breanna Zehnder | Student in an Organized Health Care Education/Training Program | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2019-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417905258 | George Alan Krzymowski | Pathology | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2006-05-04 |
| 1801963152 | John David Weiss | Pathology | 420 W Magnetic St, Marquette, MI 49855-2711 | 2006-11-30 |
| 1659448801 | Martin Hugh Matthews | Pathology | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2006-11-30 |
| 1063589216 | Randolph Edward Smith | Pathology | 420 W Magnetic St, Marquette, MI 49855-2711 | 2006-11-30 |
| 1740357086 | Chunming Liu | Pathology | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2006-11-30 |
| 1285681155 | Medical Laboratories of Marquette, PC | Pathology | 850 W Baraga Ave, Marquette, MI 49855 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1942756234 | Ahmed Alrajjal | Pathology | 459 Calvin Avenue, Grosse Pointe Farms, MI 48236-3236 | 2016-08-28 |
| 1649630435 | Barry Dewitt | Pathology | 11345 Greenview Dr, Fenton, MI 48430-2591 | 2016-03-07 |
| 1922467919 | Wilford E. Maldonado | Pathology | 4722 Huron Hill Dr, Okemos, MI 48864-2052 | 2016-02-18 |
| 1144636895 | Ramya Gadde | Pathology | 2799 W.grand Boulevard,henry Ford Hospital, Detroit, MI 48202-2608 | 2014-07-02 |
| 1710329206 | Yulei Shen | Pathology | 1546 Brentwood Dr, Troy, MI 48098-2713 | 2013-07-24 |
| 1437596046 | John P Sherbeck | Pathology | 5305 East Huron River Drive, Ann Arbor, MI 48106 | 2013-05-23 |
| 1942552336 | Kusum Kumar | Pathology | 3885 Highwood Pl, Okemos, MI 48864-3790 | 2012-10-09 |
| 1073864898 | Karel Kithier | Pathology | 5022 Temple Drive, Sterling Heights, MI 48310-4067 | 2012-09-20 |
| 1306191085 | Nathan Stepanek Shaller | Pathology | 1301 Catherine Street, Ann Arbor, MI 48109-5602 | 2012-07-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.