Provider Demographics
NPI:1073715744
Name:KLINK, JOSEPH CLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CLAIR
Last Name:KLINK
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-2030
Mailing Address - Fax:239-343-4117
Practice Address - Street 1:8931 COLONIAL CENTER DR STE 401
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7809
Practice Address - Country:US
Practice Address - Phone:239-396-8930
Practice Address - Fax:239-396-8932
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070364A208800000X
OH097271208800000X
FLME159547208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116024200Medicaid