Healthcare Provider Details

I. General information

NPI: 1245681212
Provider Name (Legal Business Name): MARGARET KLEINOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET FRANCES VOGAN PA

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARTHA JEFFERSON DR FL 4
CHARLOTTESVILLE VA
22911-4668
US

IV. Provider business mailing address

PO BOX 79777
BALTIMORE MD
21279-0777
US

V. Phone/Fax

Practice location:
  • Phone: 434-654-8960
  • Fax: 434-652-8962
Mailing address:
  • Phone: 434-654-7794
  • Fax: 434-654-8962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005393
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: