Healthcare Provider Details

I. General information

NPI: 1487745485
Provider Name (Legal Business Name): ALAN BARRY KLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 VANTAGE PL
LOUISVILLE KY
40299-6801
US

IV. Provider business mailing address

3731 ROUGE WAY
LOUISVILLE KY
40218-1540
US

V. Phone/Fax

Practice location:
  • Phone: 502-356-4377
  • Fax: 888-959-2460
Mailing address:
  • Phone: 502-807-7129
  • Fax: 866-902-0669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24316
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: