Healthcare Provider Details

I. General information

NPI: 1619551686
Provider Name (Legal Business Name): SHAYLOR KLEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

10800 KNIGHTS RD
PHILADELPHIA PA
19114-4200
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5000
  • Fax:
Mailing address:
  • Phone: 215-612-4842
  • Fax: 215-612-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number06379
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number06379
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: