Provider Demographics
NPI:1144239906
Name:KLINE, JACK ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:ARTHUR
Last Name:KLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 140
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-741-8003
Practice Address - Fax:717-741-8016
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD029009L207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA81788OtherUNISON-WMG
PA5137088OtherAETNA
PAP002843OtherGATEWAY-WMG
PA50054294OtherCAPITAL BLUE CROSS-WMG
PA2143029OtherMAMSI-WMG
MD647977OtherCAREFIRST MD BCBS
PA031972OtherHIGHMARK BLUE SHIELD
PA030056OtherJOHNS HOPKINS
PA39637OtherGEISINGER
PA0068486000OtherAMERIHEALTH 65 PA
PA1142280OtherAMERIHEALTH MERCY-WMG
PA39637OtherGEISINGER
PA031972OtherHIGHMARK BLUE SHIELD