MEDICARE: DR. KIMBERLY ANNE KLIPPENSTEIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD25333	TN
2	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	MD25333	TN
3	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	31967	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3161568	OTHER	TN	BCBS PROVIDER ID#

General Provider Information

NPI Number	:	1720036106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY ANNE KLIPPENSTEIN M.D.

Provider Business Mailing Address
First Line	:	1800 CHURCH ST
Second Line	:	SUITE 100
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2208
Country	:	US
Telephone Number	:	615-329-3624
Fax Number	:	615-329-0639

Provider Business Practice Location Address
First Line	:	1800 CHURCH ST.
Second Line	:	SUITE 100
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2233
Country	:	US
Telephone Number	:	615-329-3624
Fax Number	:	615-329-0639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	05/11/2016

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Directions to “ DR. KIMBERLY ANNE KLIPPENSTEIN M.D.” Practice Location

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