Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 07000448 | IN |
NPI | 1003831538 |
---|---|
Provider Name | Dr. Elliot L Kleinman |
First Address | Terre Haute, IN 47802-5507 |
Second Address | Terre Haute, IN 47804-4010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200347350 | (05) | IN |
T34533 | (02) | IN |