Individual
DR. JACK G KLEINMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF NEPHROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3100
(414) 805-9059
Mailing address
9200 W WISCONSIN AVE, DIVISION OF NEPHROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3100
(414) 805-9059
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
19690
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000162Z
HUMANA
—
05
—
1508817347
—
WI
Enumeration date
05/15/2006
Last updated
03/03/2014
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