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NPI Code Detail

MEDICARE: JAY A KLEIN DO PLLC

MEDICARE: JAY A KLEIN DO PLLC
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician5101008915MI

General Provider Information

NPI Number : 1457790313
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAY A KLEIN DO PLLC
Provider Business Mailing Address
First Line : PO BOX 6516
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49696-6516
Country : US
Telephone Number : 231-935-5000
Fax Number : 231-946-5477
Provider Business Practice Location Address
First Line : 2950 LAFRANIER
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4918
Country : US
Telephone Number : 231-935-5000
Fax Number : 231-946-5477
Authorized Official
Title or Position : OWNER
Name : DR. JAY A KLEIN
Credential : DO
Telephone Number : 231-935-5000
Provider Enumeration Date : 06/24/2013
Last Update Date : 11/21/2013

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