Healthcare Provider Details

I. General information

NPI: 1023013158
Provider Name (Legal Business Name): RONALD A KLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 FLEMINGSBURG RD
MOREHEAD KY
40351-1015
US

IV. Provider business mailing address

3900 E BROADWAY BLVD
TUCSON AZ
85711-3453
US

V. Phone/Fax

Practice location:
  • Phone: 606-783-6500
  • Fax: 606-783-1099
Mailing address:
  • Phone: 520-230-7682
  • Fax: 520-393-8479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number32754
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: