Provider Demographics
NPI:1033395579
Name:DR MARC R KLEIN INC
Entity Type:Organization
Organization Name:DR MARC R KLEIN INC
Other - Org Name:MARC R KLEIN
Other - Org Type:Other Name
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-423-7231
Mailing Address - Street 1:34 N BREIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3804
Mailing Address - Country:US
Mailing Address - Phone:513-423-7231
Mailing Address - Fax:
Practice Address - Street 1:34 N BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3804
Practice Address - Country:US
Practice Address - Phone:513-423-7231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001710213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2853256Medicaid
OH480031087OtherRAILROAD MEDICARE
OHDN9820OtherRAILROAD MEDICARE GROUP
OH0971570001Medicare NSC
OH480031087OtherRAILROAD MEDICARE