Provider Demographics
NPI:1760451736
Name:KLEINER, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:KLEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1633 MEDICAL CENTER POINT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-1906
Mailing Address - Country:US
Mailing Address - Phone:719-632-5109
Mailing Address - Fax:719-475-8963
Practice Address - Street 1:1633 MEDICAL CENTER POINT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-1906
Practice Address - Country:US
Practice Address - Phone:719-632-5109
Practice Address - Fax:719-475-8963
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19848207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01198480Medicaid
COE27272Medicare UPIN
CO01198480Medicaid