Provider Demographics
NPI:1407906167
Name:KLINGINSMITH, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KLINGINSMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-1852
Mailing Address - Country:US
Mailing Address - Phone:724-981-5930
Mailing Address - Fax:724-981-5213
Practice Address - Street 1:1818 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-1852
Practice Address - Country:US
Practice Address - Phone:724-981-5930
Practice Address - Fax:724-981-5213
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO2253237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1417985151Medicare UPIN