Individual
DR. JAMES A KLIEFOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 PROFESSIONAL DR, STE 150, ALTON, IL 62002-5068
(618) 463-8660
(618) 463-8666
Mailing address
1 PROFESSIONAL DR, STE 150, ALTON, IL 62002-5068
(618) 463-8660
(618) 463-8666
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036051867
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01606740682
—
IL
01
—
207219
GROUP PTAN
IL
01
—
K09770
PTAN
IL
Enumeration date
08/24/2005
Last updated
01/29/2016
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