Healthcare Provider Details

I. General information

NPI: 1912262080
Provider Name (Legal Business Name): JONATHAN THOMAS KLEINMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JONATHAN THOMAS KLEINMAN M.D.

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

PO BOX 17326
DENVER CO
80217-0326
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-6911
  • Fax: 303-788-5078
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberA128879
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036-162252
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR.0060322
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2126
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL-4376
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberDR.0060322
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: