Provider Demographics
NPI:1356335228
Name:KLEEMANN, PAUL J (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:KLEEMANN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3600 TOWNE BLVD
Mailing Address - Street 2:B-200
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5543
Mailing Address - Country:US
Mailing Address - Phone:513-424-5217
Mailing Address - Fax:513-424-0205
Practice Address - Street 1:3600 TOWNE BLVD
Practice Address - Street 2:B-200
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-5543
Practice Address - Country:US
Practice Address - Phone:513-424-5217
Practice Address - Fax:513-424-0205
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3009/T516152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0185124Medicaid
OH0185124Medicaid