Provider Demographics
NPI:1801975214
Name:KLINE, JAMES F (O D)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:KLINE
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2004
Mailing Address - Country:US
Mailing Address - Phone:908-454-2300
Mailing Address - Fax:908-454-1661
Practice Address - Street 1:1326 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2004
Practice Address - Country:US
Practice Address - Phone:908-454-2300
Practice Address - Fax:908-454-1661
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00356700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1644505Medicaid
NJ0078646Medicare PIN
NJ1644505Medicaid