Provider Demographics
NPI:1023013158
Name:KLINE, RONALD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:KLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3900 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3453
Mailing Address - Country:US
Mailing Address - Phone:520-230-7682
Mailing Address - Fax:520-393-8479
Practice Address - Street 1:3900 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3453
Practice Address - Country:US
Practice Address - Phone:520-230-7682
Practice Address - Fax:520-393-8479
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ327542086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ857352Medicaid
AZE85107Medicare UPIN
AZ857352Medicaid
AZ857352Medicaid