Provider Demographics
NPI:1245232883
Name:KLEBE, LESTER ROBERT (DPM)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:ROBERT
Last Name:KLEBE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 N TATUM BLVD
Mailing Address - Street 2:A101
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1096
Mailing Address - Country:US
Mailing Address - Phone:602-954-0777
Mailing Address - Fax:602-954-6843
Practice Address - Street 1:10555 N TATUM BLVD
Practice Address - Street 2:A101
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1096
Practice Address - Country:US
Practice Address - Phone:602-954-0777
Practice Address - Fax:602-954-6843
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0120213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ701228 01Medicaid
T41829Medicare UPIN
AZ0967960001Medicare NSC