Provider Demographics
NPI:1598052896
Name:KLEPPINGER, KYLEE KAY (OD)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:KAY
Last Name:KLEPPINGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 KING RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1402
Mailing Address - Country:US
Mailing Address - Phone:419-843-2020
Mailing Address - Fax:
Practice Address - Street 1:3723 KING RD STE 100
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1402
Practice Address - Country:US
Practice Address - Phone:419-843-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6050/T2965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV1644BMedicare PIN
WV1644AMedicare PIN
WV1644CMedicare PIN