Healthcare Provider Details

I. General information

NPI: 1609887702
Provider Name (Legal Business Name): FAR OAKS ORTHOPEDISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 MIAMI VALLEY DR SUITE 320
CENTERVILLE OH
45459
US

IV. Provider business mailing address

6490 CENTERVILLE BUSINESS PKWY
CENTERVILLE OH
45459
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-5309
  • Fax: 937-433-1340
Mailing address:
  • Phone: 937-433-5309
  • Fax: 937-433-1340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN MICHAEL KLEINHENZ
Title or Position: GENERAL PARTNER
Credential: M.D.
Phone: 937-433-5309