Healthcare Provider Details

I. General information

NPI: 1982946141
Provider Name (Legal Business Name): LINDSAY TYROL KLEEMAN-FORSTHUBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY TYROL KLEEMAN MD

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ALLEN ST
RUTLAND VT
05701-4560
US

IV. Provider business mailing address

160 ALLEN ST
RUTLAND VT
05701-4560
US

V. Phone/Fax

Practice location:
  • Phone: 802-775-2937
  • Fax: 802-773-2204
Mailing address:
  • Phone: 802-775-2937
  • Fax: 802-773-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDR.0060342
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number042.0015319
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: