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Individual

LEE JAMES KLEMENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
(920) 496-4705
Mailing address
835 S. VANBUREN ST., GREEN BAY, WI 54301
(920) 496-4700
(920) 496-4705

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39408
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11014110
WI
01
1326349135
CMH SB NPI
WI
01
1467583096
CMH PCC OF NPI
WI
01
1851477913
NPI CMH
WI
01
390848401050
ANTHEM
WI
01
39408-20
STATE LICENSE
WI
Enumeration date
12/06/2005
Last updated
10/11/2012
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