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General NPI Number Information
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NPI Number | 1346291184
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Entity Type | Individual
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Provider Name | FREDRICK T KLINGBEIL MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 5406 MERLE HAY RD
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City | JOHNSTON
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State | IA
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Zip | 50131-1209
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Country | US
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Telephone | 515-727-8750
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Fax | 515-727-8757
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Provider Business Mailing Address
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Address Line | 5406 MERLE HAY RD
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City | JOHNSTON
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State | IA
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Zip | 50131-1209
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Country | US
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Telephone | 515-727-8750
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Fax | 515-727-8757
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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 | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | 44608
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | MD-41458
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License Number State | IA
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