Provider Demographics
NPI:1003816398
Name:KLINE, TODD M (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:KLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MADISON ST
Mailing Address - Street 2:216
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3011
Mailing Address - Country:US
Mailing Address - Phone:720-360-6375
Mailing Address - Fax:
Practice Address - Street 1:155 S MADISON ST
Practice Address - Street 2:216
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3013
Practice Address - Country:US
Practice Address - Phone:720-360-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO417222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
533228Medicare ID - Type Unspecified
I03432Medicare UPIN