Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 0102201941 | VA |
NPI | 1003886581 |
---|---|
Provider Name | Dr. David Frederick Klink |
First Address | Lynchburg, VA 24502-2101 |
Second Address | Lynchburg, VA 24502-2101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 01/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G29008 | (02) |