Healthcare Provider Details

I. General information

NPI: 1528773629
Provider Name (Legal Business Name): PETER KLINGER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 N ALVERNON WAY STE 300
TUCSON AZ
85712-1500
US

IV. Provider business mailing address

2904 E HAWTHORNE ST
TUCSON AZ
85716-4134
US

V. Phone/Fax

Practice location:
  • Phone: 520-955-9555
  • Fax:
Mailing address:
  • Phone: 845-304-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. PETER KLINGER
Title or Position: OWNER/MEMBER
Credential: MD
Phone: 845-304-3530