| Doctor Name: | DR. ALISSA MARIE CONKLIN |
| NPI Number: | 1437318953 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MD60198764 |
| Business Practice Address: | 3950 Hollywood Rd Suite 100 Saint Joseph, MI - 490859159 |
| Business Phone Number: | 2694298010 |
| Business Fax Number: | 2694290986 |
| Mailing Address: | 6416 Deans Hill Rd, BERRIEN CENTER |
| State: | MI |
| Postal Code: | 491029750 |
| Phone Number: | 2694717741 |
| Fax Number: | 2694711581 |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 12/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | MD60198764 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |