Provider Demographics
NPI:1568742286
Name:KLINGER, KEVIN EVINS
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:EVINS
Last Name:KLINGER
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 1:28225 S 551 RD
Mailing Address - Street 2:
Mailing Address - City:PARK HILL
Mailing Address - State:OK
Mailing Address - Zip Code:74451-2861
Mailing Address - Country:US
Mailing Address - Phone:918-207-2348
Mailing Address - Fax:
Practice Address - Street 1:28225 S 551 RD
Practice Address - Street 2:
Practice Address - City:PARK HILL
Practice Address - State:OK
Practice Address - Zip Code:74451-2861
Practice Address - Country:US
Practice Address - Phone:918-207-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health