Kliefoth, James A

Kliefoth, James A is an individual health care provider with primary practice located at 1 Professional Dr Ste 150, Alton IL 62002-5068. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kliefoth, James A can be contacted via phone (618) 463-8660.

Contact Information

Primary practice address
1 Professional Dr Ste 150 Alton IL 62002-5068
Phone: (618) 463-8660
Fax: (618) 463-8666
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036051867 Illinois

Profile Details

NPI number 1043203250
LBN Legal business name Kliefoth, James A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Jan 29th, 2016 - 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 1043203250 NPPES
Illinois Other K09770 PTAN
Illinois Other 207219 PTAN
Illinois MEDICAID 01606740682 PTAN

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