Provider Demographics
NPI:1184610776
Name:KLEIN, DEBRA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JEAN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1085 K M RANCH RD
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8382
Mailing Address - Country:US
Mailing Address - Phone:406-755-4934
Mailing Address - Fax:406-755-4934
Practice Address - Street 1:1297 BURNS WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3166
Practice Address - Country:US
Practice Address - Phone:406-752-0303
Practice Address - Fax:406-752-0314
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT10760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTG 85659Medicare UPIN