Provider Demographics
NPI:1184612905
Name:KLINE, RONALD S (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:KLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:515 W MAYFIELD RD
Mailing Address - Street 2:SUITE 416
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2083
Mailing Address - Country:US
Mailing Address - Phone:817-417-8748
Mailing Address - Fax:817-419-8788
Practice Address - Street 1:515 W MAYFIELD RD
Practice Address - Street 2:SUITE 416
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2083
Practice Address - Country:US
Practice Address - Phone:817-417-8748
Practice Address - Fax:817-419-8788
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE1000208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00R326Medicare ID - Type UnspecifiedPROVIDER ID
TXC17953Medicare UPIN