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1205947868

NPI Code Detail

MEDICARE: ROGER JOHN KLEIN M.D.

MEDICARE: ROGER JOHN KLEIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	23894	KY
2	207RC0000X	Cardiovascular Disease Physician	23894	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01312545	OTHER	KY	RR MEDICARE
2	P00704455	OTHER	KY	MEDICARE-RAILROAD KY
3	P01428750	OTHER	OH	RR MEDICARE
7	P110081097	OTHER	KY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205947868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER JOHN KLEIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2379
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41105-2379
Country	:	US
Telephone Number	:	606-408-6200
Fax Number	:	606-408-6612

Provider Business Practice Location Address
First Line	:	613 23RD ST STE 230
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41101-2868
Country	:	US
Telephone Number	:	606-324-4745
Fax Number	:	606-324-4941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/07/2024

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Directions to “ ROGER JOHN KLEIN M.D.” Practice Location

Language	Start Address	Practice Location

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