Provider Demographics
NPI:1043246358
Name:KLEMEK, NEIL J (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:J
Last Name:KLEMEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:103 ALYCIA DR
Mailing Address - Street 2:STE 2
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2368
Mailing Address - Country:US
Mailing Address - Phone:859-626-0554
Mailing Address - Fax:859-626-9755
Practice Address - Street 1:103 ALYCIA DR
Practice Address - Street 2:STE 2
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2368
Practice Address - Country:US
Practice Address - Phone:859-626-0554
Practice Address - Fax:859-626-9755
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY29303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64093032Medicaid
A28971Medicare UPIN
KY1570702Medicare ID - Type Unspecified