Provider Demographics
NPI:1740236991
Name:KLINE, JOSEPH JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KLINE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:75 CAVALIER BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3961
Mailing Address - Country:US
Mailing Address - Phone:859-823-0507
Mailing Address - Fax:859-823-0521
Practice Address - Street 1:75 CAVALIER BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3961
Practice Address - Country:US
Practice Address - Phone:859-823-0507
Practice Address - Fax:859-823-0521
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY260892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000706014OtherANTHEM
KY611198057OtherFEDERAL TAX ID #
KY64260896Medicaid
KY614254OtherWELLCARE
KYP300043417Medicare PIN