Klanke, Justin L

Klanke, Justin L is an individual health care provider with primary practice located at 20 Medical Village Dr Suite 258, Edgewood KY 41017-5401. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Klanke, Justin L can be contacted via phone (859) 341-7246.

Contact Information

Primary practice address
20 Medical Village Dr Suite 258 Edgewood KY 41017-5401
Phone: (859) 341-7246
Fax: (859) 341-7867
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 53055 Minnesota

Profile Details

NPI number 1548492259
LBN Legal business name Klanke, Justin L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2009
Last updated Jun 17th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548492259 NPPES
Kentucky Other 611077369004 HEALTHNET
Kentucky MEDICAID 7100254430 HEALTHNET

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