Healthcare Provider Details

I. General information

NPI: 1821224742
Provider Name (Legal Business Name): JUDY KLEMAN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5925 N MAIN ST STE D
DAYTON OH
45415-3142
US

IV. Provider business mailing address

5925 N MAIN ST STE D
DAYTON OH
45415-3142
US

V. Phone/Fax

Practice location:
  • Phone: 937-426-9500
  • Fax: 855-482-2337
Mailing address:
  • Phone: 937-426-9500
  • Fax: 855-482-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00398
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36003671
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003671
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: