Provider Demographics
NPI:1942509518
Name:CONJESKI, JACOB M (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:M
Last Name:CONJESKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ORTHOPEDIC WAY
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-0720
Mailing Address - Fax:304-599-3962
Practice Address - Street 1:200 ORTHOPEDIC WAY
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1240
Practice Address - Country:US
Practice Address - Phone:304-599-0720
Practice Address - Fax:304-599-3962
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27649207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery