Provider Demographics
NPI:1184653701
Name:CONKLE, ROBERT BLAINE (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BLAINE
Last Name:CONKLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 LIMA AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1426
Mailing Address - Country:US
Mailing Address - Phone:419-423-4700
Mailing Address - Fax:419-423-6693
Practice Address - Street 1:1206 LIMA AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1426
Practice Address - Country:US
Practice Address - Phone:419-423-4700
Practice Address - Fax:419-423-6693
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT48717Medicare UPIN
OHCO0609021Medicare ID - Type Unspecified