Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 32754 | AZ |
NPI | 1023013158 |
---|---|
Provider Name | Dr. Ronald A Kline |
First Address | Tucson, AZ 85711-3453 |
Second Address | Tucson, AZ 85711-3453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 15/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
857352 | (05) | AZ |
E85107 | (02) | AZ |