Provider Demographics
NPI:1720115538
Name:KLINE, JAMES MELVIN (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MELVIN
Last Name:KLINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 5TH ST
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1847
Mailing Address - Country:US
Mailing Address - Phone:330-755-1454
Mailing Address - Fax:330-755-1856
Practice Address - Street 1:581 5TH ST
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1847
Practice Address - Country:US
Practice Address - Phone:330-755-1454
Practice Address - Fax:330-755-1856
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002425K207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0298502Medicaid
OH0298502Medicaid
OH0419836Medicare PIN