Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 35081125 | OH |
NPI | 1548253727 |
---|---|
Provider Name | Kevin E. Klingele |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43215-5577 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2326978 | (05) | OH |
2514292 | BCMH (01) | OH |
7375465 | AETNA (01) | OH |
H58919 | (02) | OH |