Provider Demographics
NPI:1265425169
Name:KLINGINSMITH, JOHN F (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:KLINGINSMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2914
Mailing Address - Country:US
Mailing Address - Phone:308-234-4940
Mailing Address - Fax:308-236-5692
Practice Address - Street 1:11 W 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2914
Practice Address - Country:US
Practice Address - Phone:308-234-4940
Practice Address - Fax:308-236-5692
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47074311800Medicaid
NE9516OtherBLUE CROSS BLUE SHIELD
NE264146Medicare ID - Type Unspecified
NE47074311800Medicaid