MEDICARE: DR. JONA MARIE CONKLIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME107193	FL
2	207V00000X	Obstetrics & Gynecology Physician	LL29003	SC
3	207VM0101X	Maternal & Fetal Medicine Physician	MD-39662	IA
4	207VX0000X	Obstetrics Physician	MD-39662	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073693719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONA MARIE CONKLIN MD

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-643-6888
Fax Number	:	515-643-6899

Provider Business Practice Location Address
First Line	:	5901 WESTOWN PKWY STE 225
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8297
Country	:	US
Telephone Number	:	515-643-6888
Fax Number	:	515-643-6899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/21/2024

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Directions to “ DR. JONA MARIE CONKLIN MD” Practice Location

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