MEDICARE: KENDEL L KLEIN

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	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770578569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENDEL L KLEIN

Provider Business Mailing Address
First Line	:	101 W PATTERSON ST
Second Line	:
City	:	MOUNT VERNON
State	:	MO
Zip	:	65712-1054
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 W PATTERSON ST
Second Line	:
City	:	MOUNT VERNON
State	:	MO
Zip	:	65712-1054
Country	:	US
Telephone Number	:	417-466-7700
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KENDEL L KLEIN
Credential	:	M.D.
Telephone Number	:	417-466-7700

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	11/10/2009

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Directions to “KENDEL L KLEIN ” Practice Location

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