Provider Demographics
NPI:1669671566
Name:KARL G KLINGES MD DAVID G BUTLER AND JAMES VAN ELSWYK MD PA
Entity Type:Organization
Organization Name:KARL G KLINGES MD DAVID G BUTLER AND JAMES VAN ELSWYK MD PA
Other - Org Name:DRS. BUTLER, ENGLERT, SEYMOUR, FALLON
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-871-4040
Mailing Address - Street 1:420 GRAND AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4152
Mailing Address - Country:US
Mailing Address - Phone:201-871-4040
Mailing Address - Fax:201-871-7326
Practice Address - Street 1:420 GRAND AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4152
Practice Address - Country:US
Practice Address - Phone:201-871-4040
Practice Address - Fax:201-871-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherHORIZON