Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | MOR7C20 | MO |
Y | 207PE0004X | Emergency Medical Services | R7C20 | MO |
NPI | 1134215759 |
---|---|
Provider Name | Dr. Guy R Kline |
First Address | Springfield, MO 65804-4247 |
Second Address | Springfield, MO 65804-4247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202099628 | (05) | MO |
A11180 | (02) | MO |
MOR7C20 | (05) | MO |