Provider Demographics
NPI:1861097719
Name:CONKLYN, WILLIAM EUGENE IV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EUGENE
Last Name:CONKLYN
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-9706
Mailing Address - Country:US
Mailing Address - Phone:570-223-2563
Mailing Address - Fax:
Practice Address - Street 1:5122 MILFORD RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-9706
Practice Address - Country:US
Practice Address - Phone:570-223-2563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4455261835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist