Provider Demographics
NPI:1700042405
Name:KLINGLER, JAMES H
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:KLINGLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:KLINGLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, MS LBP
Mailing Address - Street 1:RR 4 BOX 1375
Mailing Address - Street 2:
Mailing Address - City:COALGATE
Mailing Address - State:OK
Mailing Address - Zip Code:74538-9648
Mailing Address - Country:US
Mailing Address - Phone:580-927-0523
Mailing Address - Fax:580-889-4842
Practice Address - Street 1:211 E COURT ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-2000
Practice Address - Country:US
Practice Address - Phone:580-889-3799
Practice Address - Fax:580-889-4842
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health