MEDICARE: LAURA CONKLIN

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	208000000X	Pediatrics Physician	60059	GA

General Provider Information

NPI Number	:	1457206807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA CONKLIN

Provider Business Mailing Address
First Line	:	4 HILL RD
Second Line	:
City	:	WEST STOCKBRIDGE
State	:	MA
Zip	:	01266-9734
Country	:	US
Telephone Number	:	206-713-0250
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 HILL RD
Second Line	:
City	:	WEST STOCKBRIDGE
State	:	MA
Zip	:	01266-9734
Country	:	US
Telephone Number	:	206-713-0250
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ LAURA CONKLIN ” Practice Location

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