Healthcare Provider Details

I. General information

NPI: 1598707754
Provider Name (Legal Business Name): DANIEL BARRY KLEIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 ROGERS AVE STE B
FORT SMITH AR
72903
US

IV. Provider business mailing address

9000 ROGERS AVE STE B
FORT SMITH AR
72903
US

V. Phone/Fax

Practice location:
  • Phone: 479-484-6717
  • Fax: 479-484-9648
Mailing address:
  • Phone: 479-484-6717
  • Fax: 479-484-9648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number144
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: