MEDICARE: JOHN R KLEIN MD

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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	32166	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1508842881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R KLEIN MD

Provider Business Mailing Address
First Line	:	6618 E CARONDELET DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-2119
Country	:	US
Telephone Number	:	520-290-0961
Fax Number	:	520-290-0965

Provider Business Practice Location Address
First Line	:	6618 E CARONDELET DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-2119
Country	:	US
Telephone Number	:	520-290-0961
Fax Number	:	520-290-0965

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	05/10/2021

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