Charles Robert Conklin, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34.002344 Issued in OH

Practice address

323 Marion Avenue NW
Suite 100
Massillon, OH 44646

Phone

(330) 832-8800

Fax

(330) 832-3142

NPI assigned

Aug 8, 2006

Last updated

Jun 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1689683492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MARION AVENUE NW",
            "address_2": "SUITE 100",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-832-8800",
            "fax_number": "330-832-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MARION AVENUE NW",
            "address_2": "SUITE 100",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-832-8800",
            "fax_number": "330-832-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34.002344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303522",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Care Anesthesia Services Inc (Comprehensive Pain Services)
• Comprehensive Pain Services
• Perri-Anne Pillot Concialdi, CNP
• Cynthia Condon, RN
• Michael Conkle
• Connecting Care of Ohio, LLC
• Carl G Conrad, MD
• William Joseph Conway, NP-C
• Jennifer Lynne Cooper
• Thane Anthony Cope, PT, DPT

• Surgery Physician in Massillon, OH
• Providers in Massillon, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.