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General NPI Number Information
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NPI Number | 1154440048
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Entity Type | Individual
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Provider Name | THEA M KLINGBERG M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 1700 WHEELER PEARK DR.
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City | LAS VEGAS
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State | NV
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Zip | 89106
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Country | US
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Telephone | 702-383-2565
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Fax | 702-646-0298
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Provider Business Mailing Address
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Address Line | 1800 W. CHARLESTON BLVD. STE. 508
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-383-2688
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Fax | 702-671-6595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 908NV
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License Number State | NV
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