Healthcare Provider Details

I. General information

NPI: 1164520771
Provider Name (Legal Business Name): TIMOTHY R KLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 WAYNE RD HARDIN MEDICAL CENTER
SAVANNAH TN
38372
US

IV. Provider business mailing address

330 SHIPWATCH PT
SAVANNAH TN
38372-5599
US

V. Phone/Fax

Practice location:
  • Phone: 731-607-2082
  • Fax: 731-925-0278
Mailing address:
  • Phone: 731-607-2082
  • Fax: 721-925-0278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD0000018016
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: