Provider Demographics
NPI:1376748699
Name:DAVID H KLINE
Entity Type:Organization
Organization Name:DAVID H KLINE
Other - Org Name:DUPUYTRENS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-344-5628
Mailing Address - Street 1:750 WARM SPRINGS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6457
Mailing Address - Country:US
Mailing Address - Phone:208-344-5628
Mailing Address - Fax:208-345-2907
Practice Address - Street 1:750 WARM SPRINGS AVE STE A
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6457
Practice Address - Country:US
Practice Address - Phone:208-344-5628
Practice Address - Fax:208-345-2907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-04672086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty