Provider Demographics
NPI:1598767832
Name:KLINGINSMITH, CHARLES EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EUGENE
Last Name:KLINGINSMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2077
Mailing Address - Country:US
Mailing Address - Phone:636-937-9200
Mailing Address - Fax:
Practice Address - Street 1:105 BORGA BUILDING
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1136
Practice Address - Country:US
Practice Address - Phone:636-937-3207
Practice Address - Fax:636-937-5307
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2020-04-15
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
MOCE004138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO335496OtherHEALTHLINK ID NUMBER
MO1493532Other1ST HEALTH PLAN
MO17675OtherMERCY
MO418437OtherPRINCIPAL
MO4450023OtherUNITED HEALTH CARE ID #
MO15060OtherBLUE CROSS ID NUMBER
MO350053370OtherRAILROAD MEDICARE
MO144777OtherHUMANA CHOICE
MO982605OtherONE HEALTH PLAN
MO119232OtherGHP
MO982605OtherONE HEALTH PLAN
MO119232OtherGHP